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
Phone: (718) 896-3400
Fax: (718) 459-5621
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1851416713 | NPPES |
| New York | MEDICAID | 00244019 |
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