Individual
DANIELLE J KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
STONY BROOK MEDICINE 101 NICOLLS ROAD, STONY BROOK, NY 11794-0001
(631) 444-2066
Mailing address
12 FAWN LN W, SOUTH SETAUKET, NY 11720-1347
(631) 402-4120
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
307817
NY
Other
Enumeration date
08/09/2017
Last updated
08/09/2017
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