Individual
MS. GERALDINE M KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
11 SANDALWOOD AVE, APT. #2, VALLEY STREAM, NY 11581-2079
(917) 903-6498
Mailing address
11 SANDALWOOD AVE, APT. #2, VALLEY STREAM, NY 11581-2079
(917) 903-6498
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F306515
NY
Other
Enumeration date
07/02/2013
Last updated
10/29/2014
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