Individual
SEAN MICHAEL KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
GNP-BC
Contact information
Practice address
1 PENN PLZ FL 8, NEW YORK, NY 10119-0899
(347) 213-8011
Mailing address
120 W 106TH ST OFC, NEW YORK, NY 10025-3923
(347) 501-2299
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
340958
NY
Other
Enumeration date
07/12/2013
Last updated
10/29/2020
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