Active NPI
Kelia Tully
- Physical Therapy Assistant
- Sea Cliff, NY
National Provider Identifier
1417440090
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 011425-1
- Practice address
- 249 8TH Ave
Sea Cliff, NY 11579-1103 - Phone
- (607) 226-7828
- NPI assigned
- Jun 8, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 011425-1 | NY | Primary |
Addresses
Primary practice location
249 8TH Ave
Sea Cliff, NY 11579-1103
Mailing address
249 8TH Ave
Sea Cliff, NY 11579-1103
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 011425-1 | NY | MD | Pediatric Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528416000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1528416000000",
"number": "1417440090",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "249 8TH AVE",
"city": "SEA CLIFF",
"state": "NY",
"postal_code": "115791103"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "249 8TH AVE",
"city": "SEA CLIFF",
"state": "NY",
"postal_code": "115791103",
"telephone_number": "607-226-7828"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TULLY",
"first_name": "KELIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-06-08",
"last_updated": "2018-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "NY",
"license": "011425-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sea Cliff, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.