STEPHANIE LYNN KELLY (NPI# 1578999322) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578999322 |
| Entity Type | Individual |
| Full Name | STEPHANIE LYNN KELLY |
| Other Name | STEPHANIE LYNN BRONSON |
| Credential | PA-C |
| Practice Address |
1300 Roanoke Ave Riverhead NY 11901-2031 |
| Mailing Address |
51 Nathan Dr Bohemia NY 11716-1317 |
| Practice Telephone | 6315496000 |
| Mailing Telephone | 6317670015 |
| Enumeration Date | 2013-09-24 |
| Last Update Date | 2020-06-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 23017034 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740760420 | Stephanie Kelly | Counselor | 1819 S Dobson Rd Ste 115, Mesa, AZ 85202-5656 | 2018-08-21 |
| 1982067195 | Stephanie Marie Kelly | Licensed Practical Nurse | 5626 Bunbury Ter, Clay, NY 13041-6910 | 2016-04-04 |
| 1154766186 | Stephanie Albers Kelly | Technician | 2685 Leeds Ave, North Charleston, SC 29405-6861 | 2013-05-03 |
| 1710117700 | Stephanie Kelly | Physical Therapist | 11 Carnegie Ave, Street Line 2, Cold Spring Harbor, NY 11724-2016 | 2009-07-23 |
| 1619508017 | Stephanie Ann Kelly | Counselor | 207 W Morgan St, Brandon, FL 33510-4429 | 2020-02-04 |
| 1497296362 | Stephanie Lynn Kelly | Nurse Practitioner | 4475 S I 19 Frontage Rd Ste 139, Green Valley, AZ 85614-5884 | 2017-03-13 |
| 1528417912 | Stephanie Beth Hampel Kelly | Internal Medicine | 5841 S Maryland Ave Ste Mc7082, Chicago, IL 60637-1465 | 2016-06-07 |
| 1780012484 | Stephanie Lyn Kelly | Marriage & Family Therapist | 2258 Camino Ramon, San Ramon, CA 94583-1353 | 2013-10-16 |
| 1487920849 | Stephanie L Kelly | Registered Nurse | 6440 Nieman Rd, Shawnee, KS 66203-3326 | 2012-03-29 |
| 1447574595 | Stephanie Kelly | Psychologist | 3145 W Pratt Blvd, Chicago, IL 60645-4125 | 2010-03-18 |
| Street Address |
1300 ROANOKE AVE |
| City | RIVERHEAD |
| State | NY |
| Zip Code | 11901-2031 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386649804 | Central Suffolk Hospital | General Acute Care Hospital | 1300 Roanoke Ave, Riverhead, NY 11901-2031 | 2005-06-21 |
| 1427655653 | Karina Milagros Alvarez | Registered Nurse | 1300 Roanoke Ave, Riverhead, NY 11901-2058 | 2020-10-01 |
| 1598380735 | Michael Robert Cespites Jr. | Student in an Organized Health Care Education/Training Program | 1300 Roanoke Ave, Riverhead, NY 11901-2031 | 2020-06-13 |
| 1124643747 | Ariane Osterwald | Student in an Organized Health Care Education/Training Program | 1300 Roanoke Ave, Riverhead, NY 11901-2031 | 2020-06-09 |
| 1972127306 | Carolyn Alvarez | Student in an Organized Health Care Education/Training Program | 1300 Roanoke Ave, Riverhead, NY 11901-2031 | 2020-06-01 |
| 1457974172 | Sana Hassan | Student in an Organized Health Care Education/Training Program | 1300 Roanoke Ave, Riverhead, NY 11901-2031 | 2020-05-28 |
| 1407479314 | Chana Stern | Student in an Organized Health Care Education/Training Program | 1300 Roanoke Ave, Riverhead, NY 11901-2031 | 2020-05-26 |
| 1821611096 | Adrienne Clarke | Nurse Anesthetist, Certified Registered | 1300 Roanoke Ave, Riverhead, NY 11901-2058 | 2020-05-22 |
| 1982227112 | Isaac Lee | Student in an Organized Health Care Education/Training Program | 1300 Roanoke Ave, Riverhead, NY 11901-2031 | 2020-05-21 |
| 1598386120 | Mahrukh Riaz | Student in an Organized Health Care Education/Training Program | 1300 Roanoke Ave, Riverhead, NY 11901-2058 | 2020-05-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578102786 | Michael Arthur Frangeskos | Physician Assistant | 1330 Roanoke Avenue, Riverhead, NY 11901 | 2020-01-06 |
| 1922569136 | Mjd Optical Corp | Optometrist | 1053 Route 58 Roanoke Ave, Riverhead, NY 11901 | 2019-03-29 |
| 1356837702 | Justin M Liu | Physician Assistant | 31 Main Rd Ste 3, Riverhead, NY 11901 | 2018-07-09 |
| 1467943522 | North Shore Hematology Oncology Associates PC | Clinic/Center | 750 Old Country Rd Bldg 2, Riverhead, NY 11901 | 2018-05-24 |
| 1063918688 | Riverhead Volunteer Ambulance Corps Inc | Ambulance | 111 Osborn Ave, Riverhead, NY 11901 | 2018-04-03 |
| 1669977906 | Joseph Cataldo | Student in an Organized Health Care Education/Training Program | 64 Ida Lane, Riverhead, NY 11901 | 2018-03-28 |
| 1861903056 | The Flanders Northampton Volunteer Ambulance Company Inc | Ambulance | 641 Flanders Road, Flanders, NY 11901 | 2017-10-16 |
| 1336676659 | Patricia Ann Leask | Registered Nurse | 300 Center Drive Suite 250, Methadone Clinic Department of Mental Health, Riverhead, NY 11901 | 2017-05-17 |
| 1922463447 | Diana Williams-burke | Counselor | 550 East Main St Suite 103, Riverhead, NY 11901 | 2015-12-29 |
| 1699155549 | Twin Forks Optometry, Pllc | Optometrist | 25 Cranberry Street, Riverhead, NY 11901 | 2015-06-05 |
| Find all providers in zip 11901 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578102786 | Michael Arthur Frangeskos | Physician Assistant | 1330 Roanoke Avenue, Riverhead, NY 11901 | 2020-01-06 |
| 1356837702 | Justin M Liu | Physician Assistant | 31 Main Rd Ste 3, Riverhead, NY 11901 | 2018-07-09 |
| 1134405632 | Jeremiah Carrol Edington | Physician Assistant | 1228 E Main St Ste C, Riverhead, NY 11901-2677 | 2011-10-27 |
| 1285934562 | Kerri E Roesch | Physician Assistant | 34 Commerce Ave Ste 2, Riverhead, NY 11901-3118 | 2010-11-02 |
| 1205961596 | Wendy Gillian Ross | Physician Assistant | 1272 E Main St, Riverhead, NY 11901-2583 | 2007-02-23 |
| 1609938851 | David Richard Berezny Jr | Physician Assistant | 185 Old Country Rd Ste 7, Riverhead, NY 11901-2121 | 2006-12-14 |
| 1962019760 | Olivia Renee Demarco | Physician Assistant | 64 Commerce Ave, Riverhead, NY 11901-4455 | 2020-09-25 |
| 1356855282 | Eric Steven Koenigsdorf | Physician Assistant | 1300 Roanoke Ave, Riverhead, NY 11901-2031 | 2017-11-30 |
| 1447771423 | Alexis Breest | Physician Assistant | 1300 Roanoke Ave, Riverhead, NY 11901-2031 | 2017-06-29 |
| 1982062204 | Kevin Barile | Physician Assistant | 1300 Roanoke Ave, Riverhead, NY 11901-2031 | 2016-02-01 |
| Find all providers in RIVERHEAD | ||||
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| 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.