NPI:
1568958700
Provider Name:
NURSE PRACTITIONER INFANT AND CHILD HEALTHCARE, PC
Doing Business As: MICHELE KELLY LPNP, NPP
Classification:
Nurse Practitioner - 363LP0808X
Entity Type:
Organization
Specialization: Psychiatric/Mental Health
Address:
1227 MAIN STREET
SUITE 201
PORT JEFFERSON, NY
ZIP 11777
Phone:
(631) 235-2401
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NURSE PRACTITIONER INFANT AND CHILD HEALTHCARE, PC is a psychiatric/mental health nurse practitioner in Port Jefferson, NY. NURSE PRACTITIONER INFANT AND CHILD HEALTHCARE, PC NPI is 1568958700. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Michele Kelly Lpnp, Npp.
The provider's business location address is:
1227 MAIN STREET
SUITE 201
PORT JEFFERSON, NY
ZIP 11777
Phone: (631) 235-2401
Fax: (631) 689-3993
The provider's authorized official is Michele A. Triolo .
The authorized official title is President and has the following contact phone number (631) 235-2401.
The enumeration date for this NPI number is 7/10/2018 and was last updated on 7/10/2018.