Individual
KELLY IRENE NORDLAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, PA-C
Contact information
Practice address
888 OLD COUNTRY RD, PLAINVIEW, NY 11803-4914
(516) 719-3000
Mailing address
888 OLD COUNTRY RD, PLAINVIEW, NY 11803-4914
(516) 719-3000
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
023209
NY
363AS0400X
Surgical Physician Assistant
Primary
023209
NY
Other
Enumeration date
01/29/2019
Last updated
04/18/2022
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