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General NPI Number Information
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NPI Number | 1578738100
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Entity Type | Organization
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Legal Business Name | ANNE M KELLY MD PC
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Dates
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Enumeration Date | 04/24/2008
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Last Update Date | 06/28/2012
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Provider Practice Location Address
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Address Line | 333 EARLE OVINGTON BLVD OMNI BUILDING
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City | UNIONDALE
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State | NY
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Zip | 11553-3610
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Country | US
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Telephone | 516-357-8208
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Fax | 516-222-6893
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Provider Business Mailing Address
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Address Line | 333 EARLE OVINGTON BLVD OMNI BUILDING
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City | UNIONDALE
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State | NY
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Zip | 11553-3610
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Country | US
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Telephone | 516-357-8208
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Fax | 516-222-6893
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | PETER MCKINNON
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Credential |
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Telephone | 914-244-9530
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 210036-1
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License Number State | NY
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