Organization
NURSE PRACTITIONER INFANT AND CHILD HEALTHCARE, PC
Active
Other names
Michele Kelly LPNP, NPP
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MICHELE A. TRIOLO LPNP, NPP (PRESIDENT)
(631) 235-2401
Entity
Organization
Contact information
Practice address
1227 MAIN STREET, SUITE 201, PORT JEFFERSON, NY 11777
(631) 235-2401
(631) 689-3993
Mailing address
PO BOX 631, MILLER PLACE, NY 11764
(631) 235-2401
(631) 689-3993
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
380749
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F-400866-1
NY
Other
Enumeration date
07/10/2018
Last updated
07/10/2018
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