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NPI Code Detail

MEDICARE: DEBORAH KELLY

MEDICARE: DEBORAH KELLY
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 Assistant013026NY

General Provider Information

NPI Number : 1184437972
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEBORAH KELLY
Provider Business Mailing Address
First Line : 9 MOUNTAIN VIEW TER
Second Line :
City : BALLSTON LAKE
State : NY
Zip : 12019-9223
Country : US
Telephone Number : 781-439-0258
Fax Number :
Provider Business Practice Location Address
First Line : 43 SPRING ST
Second Line :
City : SCHUYLERVILLE
State : NY
Zip : 12871-1014
Country : US
Telephone Number : 781-439-0258
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/28/2025
Last Update Date : 01/28/2025

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Directions to “ DEBORAH KELLY ” Practice Location

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