Individual
KELLY R EMMERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
125 MINEOLA AVE, SUITE 200, ROSLYN HEIGHTS, NY 11577-2023
(516) 616-5500
(888) 502-6585
Mailing address
125 MINEOLA AVE, SUITE 200, ROSLYN HEIGHTS, NY 11577-2023
(516) 616-5500
(888) 502-6585
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
018867
NY
Other
Enumeration date
07/27/2015
Last updated
07/09/2019
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