Individual
MR. PETER KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSN, NP-C, OCN
Contact information
Practice address
27005 76TH AVE, ONCOLOGY BLDG., 3RD FLOOR, NEW HYDE PARK, NY 11040-1402
(718) 470-8930
Mailing address
27005 76TH AVE, ONCOLOGY BLDG., 3RD FLOOR, NEW HYDE PARK, NY 11040-1402
(718) 470-8930
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
30305589
NY
Other
Enumeration date
04/18/2011
Last updated
04/18/2011
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