Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
KELLY DALLAS, PA-C
ActivePhysician Assistant · MEDFORD, NJ
Registration Details
- NPI Number
- 1497091193
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Dec 27, 2012 (13.315666398179 yrs)
- Last Updated
- Feb 26, 2026
- License
-
25MP00300900 (NJ)
Practice Information
- Address
-
131 ROUTE 70 STE 100AMEDFORD, NJ, 080559501Browse NJ providers · Browse ZIP 08055
- Phone
- 6092679400
- Fax
- 6094515518
- Primary Specialty
-
Physician Assistant
363A00000X
Other Physician Assistant Providers in MEDFORD, NJ
| Name | Credential | NPI |
|---|---|---|
| CARLA Y. GROVATT | PA-C | 1952330524 |
| SCOTT EDWARD AUTY | P.A.-C. | 1801980917 |
| JEFFREY S DINA | PA | 1467548214 |
| MRS. COURTNEY E HOUDE | PA-C | 1992058689 |
| ANDREW S BERGMAN | PA-C | 1528499555 |
| CHRISTIAN MORENCY | PA | 1679981849 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.