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Organization

PATRICIA KELLY MEDICAL PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MICHELLE CLANCY (EVP)
(877) 646-2228
Entity
Organization

Contact information

Practice address
2171 JERICHO TPKE, SUITE 100, COMMACK, NY 11725-2937
(877) 646-2228
(877) 922-3329
Mailing address
225 WIRELESS BLVD, SUITE 102, HAUPPAUGE, NY 11788-3914
(877) 646-2228
(877) 922-3329

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
232224-1
NY

Other

Enumeration date
07/31/2015
Last updated
07/31/2015
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