Kelly, Diane
Kelly, Diane is an sole proprietor health care provider with primary practice located at 149 N Main St , Fairport NY 14450-1434. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist, which is considered as her primary health care specialty. Kelly, Diane can be contacted via phone (585) 377-2230.Contact Information
Primary practice address
149 N Main St
Fairport NY 14450-1434
Phone: (585) 377-2230
Fax: (585) 377-2312
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist | 225X00000X | 003625-1 | New York |
Profile Details
| NPI number | 1659537462 |
|---|---|
| LBN Legal business name | Kelly, Diane |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 31st, 2008 |
| Last updated | Jul 31st, 2008 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1659537462 | NPPES |
| New York | MEDICAID | 003625-1 |
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