Individual provider · NPI-1

Theresa O'Hagan-Kelly

Specialist/Technologist, Other · Forest Hills, NY

NPI number1639680077
StatusActive
Last updated in NPPESOct 12, 2017

Details

NPI
1639680077
Entity type
Individual (NPI-1)
Name
Theresa O'Hagan-Kelly
Sex
Female
Sole proprietor
No
Enumeration date
Oct 12, 2017
Last updated
Oct 12, 2017

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
246Z00000X Specialist/Technologist, Other––Yes

Practice location

7000 Austin St
Forest Hills, NY 11375-1022

Phone 718-762-7633 · Fax 718-866-8694

Mailing address

7000 Austin St Ste 200
Forest Hills, NY 11375-4739

Phone 718-762-7633 · Fax 718-886-8694

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Other Specialist/Technologist, Other providers in Forest Hills, NY