Individual
MS. SAMANTHA A. KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1000 N. VILLAGE AVE, ROCKVILLE CENTRE, NY 11570
(516) 705-1200
Mailing address
194-04 111TH ROAD, ST. ALBANS, NY 11412-2019
(718) 479-0245
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
487061
NY
Other
Enumeration date
07/27/2006
Last updated
07/08/2007
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