Individual
KELLY HART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
54 FORGE LN, LEVITTOWN, NY 11756-4944
(516) 587-1675
Mailing address
54 FORGE LN, LEVITTOWN, NY 11756-4944
(516) 587-1675
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
06/17/2015
Last updated
06/17/2015
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