Provider Demographics
NPI:1114335056
Name:ASKEW, KELLY
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:
Last Name:ASKEW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:254 S MAIN ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-3340
Mailing Address - Country:US
Mailing Address - Phone:845-638-1592
Mailing Address - Fax:845-638-1830
Practice Address - Street 1:254 S MAIN ST
Practice Address - Street 2:SUITE 400
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-3340
Practice Address - Country:US
Practice Address - Phone:845-638-1592
Practice Address - Fax:845-638-1830
Is Sole Proprietor?:No
Enumeration Date:2014-07-23
Last Update Date:2014-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator