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NPI Code Detail

MEDICARE: ANGELA KELLY

MEDICARE: ANGELA 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
1235Z00000XSpeech-Language Pathologist

General Provider Information

NPI Number : 1780052670
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGELA KELLY
Provider Business Mailing Address
First Line : 16 CHERYL LN N
Second Line :
City : FARMINGDALE
State : NY
Zip : 11735-4407
Country : US
Telephone Number : 631-398-5413
Fax Number :
Provider Business Practice Location Address
First Line : 4 FERN PL
Second Line :
City : PLAINVIEW
State : NY
Zip : 11803-4725
Country : US
Telephone Number : 516-933-4700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/09/2015
Last Update Date : 03/05/2026

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Directions to “ ANGELA KELLY ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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