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Kelly Marvullo
NPI 1699022830 · on the registry since 2012
Practice
- Address
- 43 Dorchester Road
Lake Ronkonkoma, NY 11779 - Phone
- (631) 278-2556
Registry record
- Primary taxonomy
- Specialist
174400000X
- Licence states on file
- NY
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2012-08-07
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in New York