NPI 1811146772

Gerard P Kelly, LMT

Practitioner Mechanotherapist Massapequa, NY

Practice location

Address: 550 Broadway STE 201, Massapequa, NY 11758-5013
Phone: (516) 815-3134

Registered specialties

Mechanotherapist Primary

Other Service Providers Taxonomy 172M00000X Licence 008693 (NY)

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Registry record

NPI: 1811146772
Entity type: Individual
Sex (as registered): Male
NPI issued: 16 Sep 2008
Record last updated: 16 Sep 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.