COLLEEN KELLY (NPI# 1972755205) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1972755205 |
Entity Type | Individual |
Full Name | COLLEEN KELLY |
Credential | P.A. |
Practice Address |
763 Larkfield Rd Fl 2 Commack NY 11725-3131 |
Practice Telephone | 6314622225 |
Practice Fax Number | 6316702643 |
Mailing Telephone | 6314622225 |
Mailing Fax Number | 6316702643 |
Enumeration Date | 2008-10-17 |
Last Update Date | 2008-10-17 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
010544 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1417451980 | Colleen Anne Kelly | Student in an Organized Health Care Education/Training Program | Menino Building, Dowling 3 South Resident Mailboxes, 1 Boston Medical Center Place, Boston, MA 02118 | 2018-03-20 |
1982068474 | Colleen Kelly | Counselor | 3208 Lake Park Way, 105, Longmont, CO 80503-7822 | 2016-04-11 |
1023498565 | Colleen Emma Kelly | Behavioral Analyst | 48 Aberdeen Rd, Arlington, MA 02476-5752 | 2015-05-29 |
1386714590 | Colleen J Kelly | Nurse Practitioner | Walton High School, 2780 Reservoir Avenue, Bronx, NY 10468 | 2006-11-08 |
1801839121 | Colleen Elizabeth Kelly | Pediatrics | 21 Totman Street, #2, Quincy, MA 02169 | 2006-06-14 |
1205440591 | Colleen Kelly | Social Worker | 7701 13th Ave, Brooklyn, NY 11228-2413 | 2020-09-03 |
1265068696 | Colleen Kelly | Physical Therapist | 460 Amherst St, Nashua, NH 03063-1220 | 2020-03-17 |
1790320414 | Colleen Kelly | Occupational Therapist | 3761 Knollcroft St, Easton, PA 18045-3026 | 2019-11-18 |
1407400419 | Colleen Lora Jaimie Kelly | Nurse Practitioner | 2111 Neuse Blvd Ste J, New Bern, NC 28560-4318 | 2019-07-29 |
1811457815 | Colleen Hamm Kelly | Surgery | 3300 Gallows Rd, Falls Church, VA 22042-3307 | 2019-03-25 |
Street Address |
763 LARKFIELD RD FL 2 |
City | COMMACK |
State | NY |
Zip Code | 11725-3131 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1982608592 | Neal H Frauwirth | Pain Medicine | 763 Larkfield Rd Fl 2, Commack, NY 11725 | 2005-06-10 |
1801133160 | Mohammed Weiss Sanzar | Physician Assistant | 763 Larkfield Rd Fl 2, Commack, NY 11725-3131 | 2013-01-07 |
1851450977 | Robert Anthony Riselvato | Emergency Medicine | 763 Larkfield Rd Fl 2, Commack, NY 11725-3131 | 2006-12-06 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1699322131 | Amanda Grace Acebedo | Student in an Organized Health Care Education/Training Program | 785 Larkfield Rd, Commack, NY 11725 | 2019-08-20 |
1922667716 | Diana Mcnamara | Social Worker | 13 Audrey Lane, Commack, NY 11725 | 2019-06-06 |
1821504333 | Amy Koenig | Specialist | 787 Larkfield Rd, Commack, NY 11725 | 2017-12-19 |
1437661501 | Commack Chemist Inc | Pharmacy | 6216 Jericho Turnpike, Commack, NY 11725 | 2017-10-30 |
1285168880 | Stephanie Arico | Counselor | 14 Silver Pond Cir, Commack, NY 11725 | 2017-04-20 |
1235684432 | Ams Primary Medical Care House Calls,pc | Home Health | 6277 Jericho Tpk, Commack, NY 11725 | 2016-08-18 |
1376927459 | Min Sun Park | Dentist | All About Smiles Pediatric Dentistry, 5036 Jericho Turnpike Suite #307, Commack, NY 11725 | 2015-07-17 |
1467843748 | Joanna Keegan | Pharmacy Technician | 98 Veterans Memorial Highway, Commack, NY 11725 | 2015-02-09 |
1275936841 | Jennie Bernstein | Social Worker | 368 Veterans Hwy Ste 2, Commack, NY 11725 | 2014-09-26 |
1417362021 | Diana Matira Yildirim | Pediatrics | 646 Commack Road, Commack, NY 11725 | 2014-06-23 |
Find all providers in zip 11725 |
Taxonomy Code | 363AS0400X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Surgical Technologist |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1225052277 | Scott Michael Gressin | Physician Assistant | 763 Larkfield Rd, Commack, NY 11725-3131 | 2006-07-26 |
1124042130 | Michael Osipoff | Physician Assistant | 763 Larkfield Rd, 2nd Floor, Commack, NY 11725-3131 | 2006-07-26 |
1831113745 | Kristopher John Stillwell | Physician Assistant | 763 Larkfield Rd, 2nd Floor, Commack, NY 11725-3131 | 2006-07-26 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1205434727 | Julia Loren Bartsch | Physician Assistant | 11791 Genesee St, Alden, NY 14004-9713 | 2020-10-16 |
1295347078 | Alana Janine Miller | Physician Assistant | 1060 5th Ave # 1b, New York, NY 10128-0104 | 2020-08-21 |
1336768647 | Abul Sarker | Physician Assistant | 2 Sagamore Ave, Suffern, NY 10901-7412 | 2020-04-16 |
1689200412 | Margaret Ann Sullivan | Physician Assistant | 7011 108th St Apt 4l, Forest Hills, NY 11375-4407 | 2020-03-12 |
1376177527 | Anabell Marina Lopez Plaza | Physician Assistant | 12 Berrywood Ct, Bay Shore, NY 11706-2058 | 2020-02-26 |
1154969053 | Joshua Reyes | Physician Assistant | 8839 Saint James Ave, Elmhurst, NY 11373 | 2019-12-11 |
1831736602 | Ll Physician Assistant PC | Physician Assistant | 2279 Coney Island Ave Fl 2, Brooklyn, NY 11223-3337 | 2019-11-29 |
1992348775 | Nafiur Rahman Chowdhury | Physician Assistant | 8268 164th St Rm A3-65, Jamaica, NY 11432-1121 | 2019-10-23 |
1376194720 | Sarah Van Eenenaam | Physician Assistant | Adult Cardiac Surgery, 750 East Adams St, Syracuse, NY 13210 | 2019-09-26 |
1578114377 | Matthew Newmark Eisenstein | Physician Assistant | 3260 43rd St Apt 2r, Astoria, NY 11103-2745 | 2019-09-23 |
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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.