MEDICARE: KELLY CURRY PTA

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
1	225200000X	Physical Therapy Assistant

General Provider Information

NPI Number	:	1427554559
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELLY CURRY PTA

Provider Business Mailing Address
First Line	:	46 MAIN ST
Second Line	:
City	:	YAPHANK
State	:	NY
Zip	:	11980-1500
Country	:	US
Telephone Number	:	631-813-8195
Fax Number	:

Provider Business Practice Location Address
First Line	:	240 MEETING HOUSE LN
Second Line	:
City	:	SOUTHAMPTON
State	:	NY
Zip	:	11968-5090
Country	:	US
Telephone Number	:	631-726-8520
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/05/2018
Last Update Date	:	04/05/2018

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Directions to “ KELLY CURRY PTA” Practice Location

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