Individual
KELLY BISSEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
161 FORT WASHINGTON AVE, NEW YORK, NY 10032-3729
(646) 317-4805
(212) 305-8111
Mailing address
630 W 168TH ST # 4, NEW YORK, NY 10032-3725
(646) 317-4805
(212) 305-8111
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
637619
NY
363LA2200X
Adult Health Nurse Practitioner
Primary
F308554
NY
Other
Enumeration date
01/28/2017
Last updated
10/04/2018
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