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NPI Code Detail

MEDICARE: MS. ANNE B. KELLY LMSW

MEDICARE: MS. ANNE B. KELLY LMSW
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
11041C0700XClinical Social Worker072728-1NY

General Provider Information

NPI Number : 1699857409
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ANNE B. KELLY LMSW
Provider Business Mailing Address
First Line : 663 DEGRAW ST
Second Line : #1
City : BROOKLYN
State : NY
Zip : 11217-3111
Country : US
Telephone Number : 845-548-1335
Fax Number :
Provider Business Practice Location Address
First Line : 333 AVENUE X
Second Line :
City : BROOKLYN
State : NY
Zip : 11223-5947
Country : US
Telephone Number : 718-339-5300
Fax Number : 718-339-9082
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/20/2006
Last Update Date : 07/08/2007

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