Individual
MR. JOHN P KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPA
Contact information
Practice address
515 BROADWAY, MASSAPEQUA, NY 11758-5005
(516) 799-2700
(516) 799-8023
Mailing address
515 BROADWAY, MASSAPEQUA, NY 11758-5005
(516) 799-2700
(516) 799-8023
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
007491
NY
Other
Enumeration date
04/08/2013
Last updated
04/08/2013
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