Abigail Kelly
Individual provider Active NPI Other Specialist/Technologist · Breesport, NY
NPI 1972376499 · NPPES record last updated Nov 6, 2023
Key facts
- NPI
- 1972376499
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Other Specialist/Technologist 246Z00000X
- Practice address
- 223 1St St
Breesport, NY 14816-9701 - Phone
- (607) 481-5012
- NPI assigned
- Nov 6, 2023
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Other Specialist/Technologist | 246Z00000X | Yes |
Addresses
Primary practice location
223 1St St
Breesport, NY 14816-9701
Mailing address
223 1St St
Breesport, NY 14816-9701
Phone (607) 481-5012
Other providers in Breesport, NY
All providers in Breesport, NY · Other Specialist/Technologist in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 6, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.