Individual
KATHLEEN KILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AGPCNP-BC
Contact information
Practice address
109 4TH ST, NEW HYDE PARK, NY 11040-4117
(516) 319-1126
Mailing address
109 4TH ST, NEW HYDE PARK, NY 11040-4117
(516) 319-1126
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F304168-1
NY
Other
Enumeration date
02/18/2021
Last updated
02/18/2021
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