Individual
KELLY-ANN LEAH MUNGROO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
475 SEAVIEW AVE, STATEN ISLAND, NY 10305-3436
(718) 226-9000
Mailing address
475 SEAVIEW AVE, STATEN ISLAND, NY 10305-3436
(718) 226-9000
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
329635
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/16/2021
Last updated
07/18/2024
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