Individual provider · Type 1 NPI
Kellie Ann Connelly, RETAIL PROVIDER
Durable Medical Equipment & Medical Supplies · Altamont, NY
NPI number
1104419209
Active · reactivated Sep 12, 2022
Practice location
798 Meadowdale Rd
Altamont, NY 12009-4710
Fax (518) 861-6840
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Durable Medical Equipment & Medical Supplies Primary | 332B00000X | None listed |
Durable Medical Equipment & Medical Supplies: A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.
About NPI 1104419209
Kellie Ann Connelly, RETAIL PROVIDER's National Provider Identifier is 1104419209, issued on Feb 19, 2021. The primary taxonomy on file is Durable Medical Equipment & Medical Supplies (332B00000X), and the practice location is in Altamont, NY. The record was last updated on Sep 12, 2022.