Provider Demographics
NPI:1982312823
Name:KELLY, BRITTNEY LYNN (AUD)
Entity Type:Individual
Prefix:DR
First Name:BRITTNEY
Middle Name:LYNN
Last Name:KELLY
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 REST CT
Mailing Address - Street 2:
Mailing Address - City:FARMINGVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11738-1667
Mailing Address - Country:US
Mailing Address - Phone:631-560-6675
Mailing Address - Fax:
Practice Address - Street 1:771 NEW YORK AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-4221
Practice Address - Country:US
Practice Address - Phone:631-673-5820
Practice Address - Fax:631-673-5825
Is Sole Proprietor?:No
Enumeration Date:2022-11-09
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003153231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist