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NPI Code Detail

MEDICARE: KELLY MAGUIRE

MEDICARE: KELLY MAGUIRE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225200000XPhysical Therapy Assistant011348NY

General Provider Information

NPI Number : 1891203931
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLY MAGUIRE
Provider Business Mailing Address
First Line : 1249 PACIFIC ST APT 1F
Second Line :
City : BROOKLYN
State : NY
Zip : 11216-3009
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4302 NEW UTRECHT AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11219-1831
Country : US
Telephone Number : 718-686-9600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/10/2018
Last Update Date : 01/10/2018

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Directions to “ KELLY MAGUIRE ” Practice Location

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