Stephanie Kelly, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

0121341 Issued in NY

Practice address

11 Carnegie Ave
Street Line 2
Cold Spring Harbor, NY 11724-2016

Phone

(631) 363-6012

NPI assigned

Jul 23, 2009

Last updated

Mar 22, 2013By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1248307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363910400000",
    "number": "1710117700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 CARNEGIE AVE",
            "city": "COLD SPRING HARBOR",
            "state": "NY",
            "postal_code": "117242016",
            "telephone_number": "631-363-6012",
            "fax_number": "631-363-4740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 CARNEGIE AVE",
            "address_2": "STREET LINE 2",
            "city": "COLD SPRING HARBOR",
            "state": "NY",
            "postal_code": "117242016",
            "telephone_number": "631-363-6012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "STEPHANIE",
        "name_prefix": "Ms.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-23",
        "last_updated": "2013-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "0121341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mellisa Ann Jewels, M.A.
• Catherine Juliano, LMSW
• Peter Juliano, LCSW
• Patricia Kalvar, D.P.M.
• Brigitte Kaplan
• Susan Klosiewicz, MS ED
• Nicole Knudsen
• Theodore Stephen Kurtz
• Jaclyn A Kurz, LMSW
• Pamela Sue Lawson, OTR

• Physical Therapist in Cold Spring Harbor, NY
• Providers in Cold Spring Harbor, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2013; 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.