Organization
JPK ANESTHESIA SERVICES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN KELLY DO (PRESIDENT)
(516) 578-3028
Entity
Organization
Contact information
Practice address
2200 NORTHERN BLVD STE 100D, GREENVALE, NY 11548-1219
(516) 243-8521
Mailing address
17 KNOLLWOOD RD, MUTTONTOWN, NY 11545
(800) 720-1664
(207) 753-2020
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Enumeration date
03/16/2020
Last updated
03/16/2020
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