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Individual
KELLY ANNE MARKISELLO
Active
Individual
KELLY ANNE MARKISELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
024159
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05937375
—
NY
Enumeration date
10/02/2019
Last updated
04/02/2021
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