KELLY JOCELYN KREIS (NPI# 1356615504) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356615504 |
| Entity Type | Individual |
| Full Name | KELLY JOCELYN KREIS |
| Credential | RN, LMT |
| Practice Address |
2500 Route 347 Suite 8d Stony Brook NY 11790-2555 |
| Practice Telephone | 5163810276 |
| Mailing Telephone | 5163810276 |
| Enumeration Date | 2012-03-06 |
| Last Update Date | 2012-03-06 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163WM1400X |
Registered Nurse Specialization: Nurse Massage Therapist (NMT) |
020418-1 | NY | Nursing Service Providers |
| Y | 163WM1400X |
Registered Nurse Specialization: Nurse Massage Therapist (NMT) |
640956-1 | NY | Nursing Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | NYS LICENSED MASSAGE THERAPIST | 020418-1 | 01 |
| NATIONALLY CERTIFIED FOR THERAPEUTIC MASSAGE AND BODYWORK | 527755-07 | 01 | |
| NY | NY REGISTERED PROFESSIONAL NURSE | 6409561 | 01 |
| Street Address |
2500 ROUTE 347 SUITE 8D |
| City | STONY BROOK |
| State | NY |
| Zip Code | 11790-2555 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205833704 | Brooke Carol Moore | Internal Medicine | 2500 Route 347, Bldg 14a, Stony Brook, NY 11790-2554 | 2005-06-30 |
| 1699025635 | Elyse S Rafal M D P C | Dermatology | 2500 Route 347, Building 22a, Stony Brook, NY 11790-2555 | 2012-09-18 |
| 1457609372 | Mark D Epstein M D P C | Specialist | 2500 Route 347, Building 22a, Stony Brook, NY 11790-2555 | 2012-08-27 |
| 1841396546 | Amy Wishner Steinberg | Dermatology | 2500 Route 347, Bldg 5a Amy Wishner Steinberg Md, Stony Brook, NY 11790-2555 | 2006-09-16 |
| 1578575304 | Horia Liviu Vlase | Internal Medicine | 2500 Route 347, Bldg 14a, Stony Brook, NY 11790-2554 | 2006-08-12 |
| 1710909502 | Mark L Bernstein | Internal Medicine | 2500 Route 347, Bldg 8d, Stony Brook, NY 11790 | 2006-07-24 |
| 1245271600 | Ophthalmic Consultants of Long Island | Ophthalmology | 2500 Route 347, Building 24a, Stony Brook, NY 11790-2555 | 2006-06-09 |
| 1255393567 | Mark D Epstein | Plastic Surgery | 2500 Route 347, Building 22a, Stony Brook, NY 11790-2555 | 2006-04-03 |
| 1477515781 | Elyse S. Rafal | Dermatology | 2500 Route 347, Building 22a, Stony Brook, NY 11790-2555 | 2006-04-03 |
| 1184614935 | Trevor S Wong | Physical Therapist | 2500 Route 347, Suite 8d, Stony Brook, NY 11790-2555 | 2005-10-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649807678 | Ribu Mathew | Student in an Organized Health Care Education/Training Program | Health Science Center T16, Room 020, Stony Brook, NY 11790 | 2020-03-27 |
| 1538794821 | Chaoyang Qu | Student in an Organized Health Care Education/Training Program | 9 Syncamore Dr, Stonybrook, NY 11790 | 2020-03-06 |
| 1457814824 | Brain & Spine Surgery, P.C. | Neurological Surgery | 2500 Nesconset Hwy., Bldg 18c, Stony Brook, NY 11790 | 2019-04-11 |
| 1447759741 | Susan Cuccia | Registered Nurse | 40 Sheppard Lane, Stony Brook, NY 11790 | 2018-02-02 |
| 1972022234 | Carol M Doherty | Specialist | 7 Haskel Lane, Stony Brook, NY 11790 | 2017-09-18 |
| 1972021582 | Louren M Gonzales | Nurse Practitioner | 100 Nicolls Rd Hsc Level 4 Room 120, Hsc Level 4 Room 120, Stony Brook, NY 11790 | 2017-09-04 |
| 1043740954 | Asma Khattak | Behavior Technician | 90 Quaker Path, Stony Brook, NY 11790 | 2017-06-13 |
| 1427452846 | Christina Georgia | Registered Nurse | 36 Ivy League Lane, Stony Brook, NY 11790 | 2014-10-14 |
| 1124361654 | Mandeep Kainth | Student in an Organized Health Care Education/Training Program | Department of Medicine Hsc Level 16, 020, Suny Stony Brook, Stony Brook, NY 11790 | 2013-04-03 |
| 1922357144 | Audry M Luciano | Registered Nurse | 2500 Nesconset Hwy Bldg 23, Stony Brook, NY 11790 | 2012-09-04 |
| Find all providers in zip 11790 | ||||
| Taxonomy Code | 163WM1400X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Nurse Massage Therapist (NMT) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952769523 | Jill Scheltz | Registered Nurse | 554 Linden St, Rochester, NY 14620-2421 | 2016-02-10 |
| 1487896098 | Patricia D Refermat | Registered Nurse | 38 Lake St, Hamburg, NY 14075-4908 | 2009-03-27 |
| City | STONY BROOK |
| Zip Code | 11790 |
Please comment or provide details below to improve the information on KELLY JOCELYN KREIS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.