Individual
NICOLE KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
505 E 70TH ST FL 3, NEW YORK, NY 10021-4872
(646) 962-5437
Mailing address
PO BOX 29751, NEW YORK, NY 10087-9751
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
318881
NY
Other
Enumeration date
03/21/2019
Last updated
08/13/2024
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