Erin Kathleen Kelly | Staten Island, NY • PECOS Search

Erin Kathleen Kelly

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

475 Seaview Ave, Staten Island, NY 10305-3436

(718) 226-9000 (631) 928-0362

PECOS Enrollment

Based on the most recent information from CMS, provider Erin Kathleen Kelly does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 5 days ago.

Profile Details

Provider ID
1184856163
Provider Type
Individual
Full Name
Kelly, Erin Kathleen
Credential
PA-C

Gender
Female
Sole Proprietor
Yes
Enumeration Date
8/10/2009
Last Updated
8/10/2009

Contact Information

Practice Location

475 Seaview Ave, Staten Island, NY 10305-3436

Unlisted Fax

Mailing Location

9 Hilltop Dr, Mount Sinai, NY 11766-1714

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License 012622 New York