Individual provider · Type 1 NPI

Kelly Kennedy-Bauza

Student in an Organized Health Care Education/Training Program · Dix Hills, NY

NPI number 1174450191 Active

Practice location

43 Arista Dr
Dix Hills, NY 11746-4920

Call (631) 683-4393 Map

Mailing address

1985 Marcus Ave Ste 100
New Hyde Park, NY 11042-2025

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1174450191

Kelly Kennedy-Bauza's National Provider Identifier is 1174450191, issued on May 5, 2026. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Dix Hills, NY. The record was last updated on May 5, 2026.