Individual
KELLY M SIDARI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
425 PENNSYLVANIA AVE, ELMIRA, NY 14904-1762
(607) 737-5565
(607) 737-2980
Mailing address
425 PENNSYLVANIA AVE, ELMIRA, NY 14904-1762
(607) 737-5565
(607) 737-2980
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
251B
—
NY
Enumeration date
06/09/2012
Last updated
06/09/2012
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