KAG PROFESSIONAL NURSE PRACTITIONER IN ADULT HEALTH PLLC is an adult health nurse practitioner in Medford, NY. KAG PROFESSIONAL NURSE PRACTITIONER IN ADULT HEALTH PLLC NPI is 1295391985. The provider is registered as an organization entity type and is a single specialty group.
The provider's business location address is:
3115 HORSEBLOCK RD
MEDFORD, NY
ZIP 11763-526
Phone: (631) 872-2995
The provider's authorized official is Kelly Ann Godberson .
The authorized official title is Nurse Practitioner and has the following contact phone number (631) 872-2995.
The enumeration date for this NPI number is 5/17/2019 and was last updated on 10/24/2022.