Doctor Name: | DEBORAH KELLY |
NPI Number: | 1205025814 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | 330845 |
Business Practice Address: | 645 Marble Ave Thornwood, NY - 105941062 |
Business Phone Number: | 9147691600 |
Business Fax Number: | 9147691610 |
Mailing Address: | 60 Goldens Bridge Rd, KATONAH |
State: | NY |
Postal Code: | 105363447 |
Phone Number: | 9142323255 |
Fax Number: | 9142323266 |
NPI Enumeration Date: | 10/19/2007 |
NPI Last Update Date: | 04/13/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 330845 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |