Individual
KELLY MARIE MERRILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
75 SMITH ROAD, RIDGE, NY 11961
(914) 384-1065
Mailing address
75 SMITH RD, RIDGE, NY 11961-2542
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
756382
NY
Other
Enumeration date
08/21/2018
Last updated
08/21/2018
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