Individual
KELLY ANNE CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, CDN
Contact information
Practice address
2201 HEMPSTEAD TPKE, EAST MEADOW, NY 11554-5400
(516) 572-0123
Mailing address
6 PO LN, HICKSVILLE, NY 11801-3724
(516) 296-2886
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86118181
NY
Other
Enumeration date
10/20/2023
Last updated
10/20/2023
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