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Ms. Kelly Teresa Marvullo
Specialist in Lake Ronkonkoma, New York
NPI 1699022830

Kelly Teresa Marvullo is a Specialist based in Lake Ronkonkoma, NY. Kelly Teresa Marvullo practices in Lake Ronkonkoma, NY. The NPI Number for Kelly Teresa Marvullo is 1699022830 and holds a License No. 1135283 (New York).

The current practice location address for Kelly Teresa Marvullo is 43 Dorchester Road, Lake Ronkonkoma, NY and can be reached out via phone at 631-278-2556.

Location: 43 Dorchester Road, Lake Ronkonkoma, NY, 11779-1616
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1699022830
Provider Name
Kelly Teresa Marvullo
Credential
Provider Entity Type
Individual
Gender
Female
Address
43 Dorchester Road, Lake Ronkonkoma, NY, 11779-1616
Phone Number
631-278-2556
Fax Number
Provider Enumeration Date
08/07/2012
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
43 Dorchester Road
City
Lake Ronkonkoma
State
New York
Zip
11779-1616
Phone Number
631-278-2556
Fax Number
person
Provider Business Mailing Address Details
Address
43 Dorchester Road
City
Lake Ronkonkoma
State
New York
Zip
11779-1616
Phone Number
631-278-2556
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
1135283 (New York)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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