Kelly, Mary Gene

Kelly, Mary Gene is an individual health care provider with primary practice located at 9729 64Th Rd , Rego Park NY 11374-2240. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Kelly, Mary Gene can be contacted via phone (718) 896-3400.

Contact Information

Primary practice address
9729 64Th Rd Rego Park NY 11374-2240
Fax: (718) 459-5621
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 070513 New York

Profile Details

NPI number 1851416713
LBN Legal business name Kelly, Mary Gene
Credentials LMSW
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 20th, 2007
Last updated Jul 8th, 2007 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1851416713 NPPES
New York MEDICAID 00244019

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