Organization
LESA A. KELLY MD PLLC
Active
Organization
LESA A. KELLY MD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LESA A KELLY MD (SOLE PROPRIETOR)
(914) 637-2663
Entity
Organization
Contact information
Practice address
77 QUAKER RIDGE RD, SUITE 200A, NEW ROCHELLE, NY 10804-2808
(914) 637-2663
Mailing address
77 QUAKER RIDGE RD, SUITE 200A, NEW ROCHELLE, NY 10804-2808
(914) 637-2663
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A100000388
MEDICARE PTAN
NY
Enumeration date
09/11/2008
Last updated
11/18/2008
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