Individual
MRS. CAROLINE M KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
4 VINCENT PL, OAKDALE, NY 11769-1713
(631) 567-4860
Mailing address
4 VINCENT PL, P.O. BOX 9, OAKDALE, NY 11769-1713
(631) 567-4860
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
371517-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01763208
—
NY
Enumeration date
06/21/2007
Last updated
07/09/2007
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