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DR. KELLY GLENN SPEICH MD NPI 1164926770


NPI Information

NPI: 1164926770
Provider Name: DR. KELLY GLENN SPEICH, MD
Classification: Student in an Organized Health Care Education/Training Program - 390200000X
Entity Type: Individual

PECOS Registration: Yes

Address:
90 BERGEN ST STE 8100
NEWARK, NJ
ZIP 07103
Phone: (973) 972-4588
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DR. Kelly Glenn Speich, MD is a student in an organized health care education training program in Newark, NJ with 6 years of experience. The provider is an individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. DR. Kelly Glenn Speich, MD NPI is 1164926770. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: COOPER MEDICAL SCHOOL OF ROWAN UNIVERSITY
Graduation Year:2018

The provider's business location address is:

90 BERGEN ST STE 8100
NEWARK, NJ
ZIP 07103-425
Phone: (973) 972-4588

The NPI 1164926770 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/19/2018 and was last updated on 3/19/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1390200000XStudent in an Organized Health Care Education/Training ProgramNEW JERSEYYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.