DR. KELLY KIM LY (NPI# 1801914742) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801914742 |
| Entity Type | Individual |
| Full Name | DR. KELLY KIM LY |
| Credential | MD |
| Practice Address |
227 Madison St Pediatrics Dept New York NY 10002-7537 |
| Practice Telephone | 2122387260 |
| Practice Fax Number | 2122387799 |
| Mailing Telephone | 2122387260 |
| Mailing Fax Number | 2122387799 |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2011-07-12 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080A0000X |
Pediatrics Specialization: Adolescent Medicine |
224534 | NY | Allopathic & Osteopathic Physicians |
| N | 2080A0000X |
Pediatrics Specialization: Adolescent Medicine |
25MA07959400 | NJ | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073885745 | Kelly Ly | Specialist/Technologist | 328 Northbank Ct Apt 37, Stockton, CA 95207-7611 | 2012-01-27 |
| 1134166333 | Kelly L Ly | Anesthesiology | 1150 Veterans Blvd., Kaiser Redwood City Medical, Redwood City, CA 94063 | 2006-05-31 |
| 1447603394 | Kelly Ly | Optometrist | 182 W 32nd St, Yuma, AZ 85364-8127 | 2016-07-15 |
| Street Address |
227 MADISON ST PEDIATRICS DEPT |
| City | NEW YORK |
| State | NY |
| Zip Code | 10002-7537 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760474753 | Mary Varghese | Dentist | 227 Madison St, New York, NY 10002-7537 | 2005-08-17 |
| 1194322404 | Estefani Restrepo | Social Worker | 227 Madison St, New York, NY 10002-7537 | 2020-10-08 |
| 1144856360 | Jacqueline Herling | Dietitian, Registered | 227 Madison St, New York, NY 10002-7537 | 2020-03-19 |
| 1578197687 | Alicia Nicole Ambrosino | Social Worker | 227 Madison St, New York, NY 10002-7537 | 2020-02-27 |
| 1013541309 | Benny Rigoberto Guillermo | Nurse Practitioner | 227 Madison St, New York, NY 10002-7537 | 2020-02-26 |
| 1750922639 | Ogochukwu Jennifer Anagboso | Nurse Practitioner | 227 Madison St, New York, NY 10002-7537 | 2019-10-02 |
| 1578126751 | Adetokunbo Ibitoye | Respiratory Therapist, Registered | 227 Madison St, New York, NY 10002-7537 | 2019-04-15 |
| 1811454176 | Malaica Analyn Benjamin | Physician Assistant | 227 Madison St, New York, NY 10002-7537 | 2019-02-22 |
| 1710457056 | Nyc Health and Hospitals | Clinic/Center | 227 Madison St, New York, NY 10002-7537 | 2018-11-29 |
| 1801377866 | Andrea Cannalunga | Social Worker | 227 Madison St, New York, NY 10002-7537 | 2018-08-27 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437776507 | Betances Health Center | Dietitian, Registered | 280 Henry Street, New York, NY 10002 | 2020-07-06 |
| 1558996041 | John X Wang Acupuncture PC | Acupuncturist | 27 East Broadway, 6fl, New York, NY 10002 | 2020-03-05 |
| 1962044776 | Min Lin | Student in an Organized Health Care Education/Training Program | 44-46 Market St Apt 6a, New York, NY 10002 | 2019-10-14 |
| 1184274540 | Brittany Irby | Community Health Worker | 189 Eldridge Street, New York, NY 10002 | 2019-09-18 |
| 1528558616 | Center for All Abilities, Inc. | Music Therapist | 136 Henry Street, New York, NY 10002 | 2018-05-14 |
| 1811490501 | Haishuang Huang | Health Educator | 87 Bowery, Fl 1, New York, NY 10002 | 2018-03-09 |
| 1174031546 | Vanessa Lisa Cruz | Specialist | 211 Eldridge Street, 3d, New York, NY 10002 | 2018-01-18 |
| 1295243889 | Robert Shum | Peer Specialist | 275 Cherry Street Apt.7a, New York, NY 10002 | 2018-01-17 |
| 1184147449 | Brooklyn Spine and Sports Medicine P.C. | Physical Medicine & Rehabilitation | 415 Grand New York Street, Apt E1707, New York, NY 10002 | 2017-07-19 |
| 1548780893 | Sana Khan | Student in an Organized Health Care Education/Training Program | 90 Rivington St, New York, NY 10002 | 2017-06-27 |
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| Taxonomy Code | 2080A0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Adolescent Medicine |
| A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346549128 | Risa Laurel Fridy | Pediatrics | 14 E 90th St # 1b, New York, NY 10128-0671 | 2011-03-20 |
| 1275766578 | Susan Spear | Pediatrics | 225 W 83rd St Apt 14f, New York, NY 10024-4960 | 2009-09-02 |
| 1952554404 | Lawrence Christopher Sullivan | Pediatrics | 346 W 22nd St Apt 3, New York, NY 10011-2670 | 2008-10-28 |
| 1043428204 | Valentin Pardo Jovellanos | Pediatrics | 20 Sherman Ave, New York, NY 10040-1654 | 2007-05-20 |
| 1336366756 | Dilia M Castanos | Pediatrics | 616 W 184th St, New York, NY 10033-3908 | 2007-04-19 |
| 1285768622 | Michael Rosenbaum | Pediatrics | 450 West End Avenue, Suite #1e, New York, NY 10024 | 2007-03-16 |
| 1275687444 | Diane Stumpf-koster | Pediatrics | 600 W 168th St, New York, NY 10032-3722 | 2007-01-23 |
| 1457405995 | Flor S De La Cadena | Pediatrics | 160 Wadsworth Ave, Suite #1, New York, NY 10033-3821 | 2007-01-22 |
| 1730239948 | Luis Cesar Ninaortega | Pediatrics | 23 East 10 St. Apt. 216, Apt. 216, New York, NY 10003 | 2007-01-11 |
| 1417015116 | Lara Gordon | Pediatrics | 215 E 79th St, New York, NY 10021-0847 | 2006-12-05 |
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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.