Individual
MRS. MARY ELLEN DEPREE KIERNAN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
800 POLY PL, BROOKLYN, NY 11209-7104
(718) 836-6600
Mailing address
1 DEVON WALK, ROCKAWAY POINT, NY 11697-1823
(718) 634-8322
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
001585
NY
Other
Enumeration date
05/20/2006
Last updated
07/08/2007
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