Provider Demographics
NPI:1750871786
Name:KELLY, ASHLEY KATE (MS OTR/L)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:KATE
Last Name:KELLY
Suffix:
Gender:F
Credentials:MS OTR/L
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Other - Last Name:
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Mailing Address - Street 1:30 VANDEWATER ST
Mailing Address - Street 2:
Mailing Address - City:FARMINGDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11735-4540
Mailing Address - Country:US
Mailing Address - Phone:516-754-7182
Mailing Address - Fax:
Practice Address - Street 1:47 HUMPHREY DR
Practice Address - Street 2:
Practice Address - City:SYOSSET
Practice Address - State:NY
Practice Address - Zip Code:11791-4022
Practice Address - Country:US
Practice Address - Phone:516-754-7182
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-15
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics