Individual
KELLY GOFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
3415 BAINBRIDGE AVE, BRONX, NY 10467-2403
(718) 741-2150
Mailing address
15042 25TH DR, FLUSHING, NY 11354-1502
Taxonomy
Speciality
Code
Description
License number
State
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
383620
NY
363LP0200X
Pediatric Nurse Practitioner
Primary
383620
NY
Other
Enumeration date
09/18/2023
Last updated
10/06/2023
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