Individual
MISS KELLY O'MELIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
681 CLARKSON AVE, BROOKLYN, NY 11203-2125
(347) 804-6007
Mailing address
14202 20TH AVE, FLUSHING, NY 11351-3000
(347) 804-6007
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
02/06/2017
Last updated
02/06/2017
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