KELLY MARIE CAVANAUGH

RIVERSIDE PEDIATRIC GROUP PC

Dr KELLY MARIE CAVANAUGH is a female medical professional, specializing in Nurse Practitioner. She graduated in 2016.

Contact

RIVERSIDE PEDIATRIC GROUP PC

506 BROADWAY
BAYONNE
NJ
070023712

Tel: 2014717012

KELLY MARIE CAVANAUGH Information

Npi 1205385077
Pac Id 3870853435
Professional Enrollment Id I20180131000643
Last Name CAVANAUGH
First Name KELLY
Middle Name MARIE
Suffix
Gender F
Credential
Medical School Name OTHER
Graduation Year 2016
Primary Specialty NURSE PRACTITIONER
Secondary Specialty 1
Secondary Specialty 2
Secondary Specialty 3
Secondary Specialty 4
All Secondary Specialties
Organization Legal Name RIVERSIDE PEDIATRIC GROUP PC
Group Practice Pac Id 3072650290
Number Of Group Practice Members 168
Line 1 Street Address 506 BROADWAY
Line 2 Street Address
Marker Of Address Line 2 Suppression
City BAYONNE
State NJ
Zip Code 070023712
Phone Number 2014717012
Hospital Affiliation Ccn 1
Hospital Affiliation Lbn 1
Hospital Affiliation Ccn 2
Hospital Affiliation Lbn 2
Hospital Affiliation Ccn 3
Hospital Affiliation Lbn 3
Hospital Affiliation Ccn 4
Hospital Affiliation Lbn 4
Hospital Affiliation Ccn 5
Hospital Affiliation Lbn 5
Professional Accepts Medicare Assignment Y

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