MRS. Kelly Shea

NPI #1194069930 in Merrick, New York

Provider Information

NPI Number: 1194069930
Entity Type: Individual
Name: MRS. Kelly Shea
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Specialist
Enumeration Date: Nov 17, 2012
Last Updated: Nov 17, 2012

Practice Location

Address: 29 W LOINES AVE
City: Merrick
State: New York
ZIP Code: 11566-3072
Phone: (516) 377-2837

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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