KELLY R PORTA

NEW HYDE PARK, NY
NPI1215112164
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363A00000X Physician Assistant
(Licence: NY  008808)
Enumeration Date2008-01-09
Last Update Date2008-01-09
Business Address
-- KELLY R PORTA PA
27005 76TH AVE
NEW HYDE PARK, NY 11040-1433
Phone number: 718-470-4455
Mailing Address
-- KELLY R PORTA PA
972 BRUSH HOLLOW RD
WESTBURY, NY 11590-1740
Phone number: 516-876-5555