Individual
ALICIA DAWN KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
24123 148TH AVE, ROSEDALE, NY 11422-3265
(718) 525-0184
Mailing address
24123 148TH AVE, ROSEDALE, NY 11422-3265
(718) 525-0184
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
548512
NY
Other
Enumeration date
06/03/2008
Last updated
06/03/2008
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