Individual
MARY CATHERINE KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
275 RIVERSIDE AVE, RIVERSIDE, CT 06878-2313
(203) 698-7403
Mailing address
275 RIVERSIDE AVE, RIVERSIDE, CT 06878-2313
(203) 698-7403
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
F381068-1
NY
Other
Enumeration date
05/06/2007
Last updated
07/08/2007
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