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NPI Code Detail

MEDICARE: KELLY CHRISTINE MCQUAID M.S. ED

MEDICARE: KELLY CHRISTINE MCQUAID M.S. ED
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
1174400000XSpecialist731738NY

General Provider Information

NPI Number : 1619492881
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLY CHRISTINE MCQUAID M.S. ED
Provider Business Mailing Address
First Line : 24 HOOD PL
Second Line :
City : CORTLANDT MANOR
State : NY
Zip : 10567-1060
Country : US
Telephone Number : 917-655-3764
Fax Number :
Provider Business Practice Location Address
First Line : 24 HOOD PL
Second Line :
City : CORTLANDT MANOR
State : NY
Zip : 10567-1060
Country : US
Telephone Number : 917-655-3764
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2017
Last Update Date : 07/21/2022

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