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General NPI Number Information
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NPI Number | 1760430318
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Entity Type | Individual
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Provider Name | MARGARET ELLEN CROTTY KELLY RN, PNP
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Gender | Female
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Dates
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Enumeration Date | 05/05/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 936 DELAWARE AVE
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City | BUFFALO
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State | NY
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Zip | 14209-1804
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Country | US
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Telephone | 716-888-1311
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Fax | 716-888-1315
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Provider Business Mailing Address
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Address Line | 54 S WARREN AVE
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City | WEST SENECA
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State | NY
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Zip | 14224-3008
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Country | US
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Telephone | 716-674-0988
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 380281
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License Number State | NY
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