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1104545037
GEORGIA KELLY-WILLIAMS
DEER PARK, NY
NPI
1104545037
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: NY 404380)
Enumeration Date
2022-08-24
Last Update Date
2022-08-24
Business Address
GEORGIA KELLY-WILLIAMS
52 TIBER AVE
DEER PARK, NY 11729-7012
Phone number: 631-404-8843
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Mailing Address
GEORGIA KELLY-WILLIAMS
52 TIBER AVE
DEER PARK, NY 11729-7012
Phone number: 631-404-8843
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