NPIMap

Organization Active NPI

Lesa a. Kelly MD PLLC

  • Dermatology Physician
  • New Rochelle, NY
National Provider Identifier
1124277348
Registry record updated Nov 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
LESA A. KELLY MD PLLC
Practice address
77 Quaker Ridge Rd
Suite 200a
New Rochelle, NY 10804-2808
Phone
(914) 637-2663
NPI assigned
Sep 11, 2008
Last updated
Nov 18, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Lesa A Kelly, MDNPI 1265598015
Title
Sole Proprietor
Phone
(914) 637-2663

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

77 Quaker Ridge Rd
Suite 200a
New Rochelle, NY 10804-2808

Mailing address

77 Quaker Ridge Rd
Suite 200a
New Rochelle, NY 10804-2808
Phone (914) 637-2663

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1221091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226966400000",
    "number": "1124277348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 QUAKER RIDGE RD",
            "address_2": "SUITE 200A",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108042808",
            "telephone_number": "914-637-2663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 QUAKER RIDGE RD",
            "address_2": "SUITE 200A",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108042808",
            "telephone_number": "914-637-2663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LESA A. KELLY MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-11",
        "last_updated": "2008-11-18",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "LESA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "914-637-2663",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Rochelle, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.