| Doctor Name: | MRS. MICHELE MARIE MATSON-KELLY |
| NPI Number: | 1487786174 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN |
| License Number: | 00492475 |
| Business Practice Address: | 2 Woodridge Putnam Valley, NY - 105793321 |
| Business Phone Number: | 8455283781 |
| Business Fax Number: | |
| Mailing Address: | 59 Cold Spring Rd, PUTNAM VALLEY |
| State: | NY |
| Postal Code: | 105791513 |
| Phone Number: | 8452842385 |
| Fax Number: | |
| NPI Enumeration Date: | 03/09/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WP0200X |
| License Number: | 00492475 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |