Individual
BRIAN NEIL KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
80 SEAVIEW BLVD, PORT WASHINGTON, NY 11050-4618
(516) 626-2799
Mailing address
6216 JERICHO TPKE, COMMACK, NY 11725-2801
(631) 219-6615
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
047032
NY
Other
Enumeration date
10/10/2022
Last updated
10/10/2022
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