Marvullo, Kelly Teresa

Marvullo, Kelly Teresa is an individual health care provider with primary practice located at 43 Dorchester Road , Lake Ronkonkoma NY 11779-1616. She recently has only one registered license in Other Service Providers / Specialist, which is considered as her primary health care specialty. Marvullo, Kelly Teresa can be contacted via phone (631) 278-2556.

Contact Information

Primary practice address
43 Dorchester Road Lake Ronkonkoma NY 11779-1616
Phone: (631) 278-2556
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 1135283 New York

Profile Details

NPI number 1699022830
LBN Legal business name Marvullo, Kelly Teresa
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 7th, 2012
Last updated Aug 7th, 2012 - about 12 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.

Request for update

Popular Providers