Individual
DR. KELLY ANN KYANKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
374 GRAND AVE, NEW HAVEN, CT 06513-3733
(203) 777-7411
Mailing address
75 HENRY ST APT 28C, BROOKLYN, NY 11201-1963
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
047473
CT
207R00000X
Internal Medicine Physician
246154
NY
Other
Enumeration date
12/31/2007
Last updated
10/21/2009
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