Provider Demographics
NPI:1679979389
Name:KIELY, KRISTY
Entity Type:Individual
Prefix:MS
First Name:KRISTY
Middle Name:
Last Name:KIELY
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 1:14160 SOUTH DR
Mailing Address - Street 2:
Mailing Address - City:WHITESTONE
Mailing Address - State:NY
Mailing Address - Zip Code:11357-1007
Mailing Address - Country:US
Mailing Address - Phone:646-468-5226
Mailing Address - Fax:
Practice Address - Street 1:14160 SOUTH DR
Practice Address - Street 2:
Practice Address - City:WHITESTONE
Practice Address - State:NY
Practice Address - Zip Code:11357-1007
Practice Address - Country:US
Practice Address - Phone:646-468-5226
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-06
Last Update Date:2014-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care