KELLY BROCK (NPI# 1992324578) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992324578 |
| Entity Type | Individual |
| Full Name | KELLY BROCK |
| Practice Address |
1 Ireland Pl Amityville NY 11701-2955 |
| Mailing Address |
351 44th St Lindenhurst NY 11757-2310 |
| Practice Telephone | 6315149750 |
| Mailing Telephone | 6315149750 |
| Enumeration Date | 2020-04-13 |
| Last Update Date | 2020-04-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133NN1002X |
Nutritionist Specialization: Nutrition, Education |
Dietary & Nutritional Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730531047 | Kelly Brock | Behavioral Analyst | 35 Revere Rd, Queensbury, NY 12804-8044 | 2016-07-11 |
| 1558679837 | Kelly Brock | Pharmacist | 1312 Olwyn Dr, Tustin, CA 92780-3834 | 2010-09-20 |
| 1891971339 | Kelly Brock | Licensed Practical Nurse | 345 Elmwood Ter, Rochester, NY 14620-3707 | 2008-01-15 |
| 1184198871 | Kelly Brock | Occupational Therapist | 6700 France Ave S Ste 300, Edina, MN 55435-1908 | 2019-01-15 |
| 1588185060 | Kelly Brock | Community/Behavioral Health | 470 Main St, Mashpee, MA 02649-2047 | 2017-07-05 |
| 1043663818 | Kelly Brock | Physician Assistant | 2350 N Lake Dr, Suite 206, Milwaukee, WI 53211-4528 | 2016-07-18 |
| 1992100275 | Kelly Brock | Specialist/Technologist | 567 N 5th St, Terre Haute, IN 47809-1903 | 2014-10-28 |
| 1922438894 | Kelly Brock | Counselor | 77 E Merrimack St, Lowell, MA 01852-1251 | 2013-11-13 |
| 1316001134 | Kelly Koga Brock | Physical Therapist | 270 International Cir # Twon, Physical Therapy, San Jose, CA 95119-1130 | 2006-12-20 |
| Street Address |
1 IRELAND PL |
| City | AMITYVILLE |
| State | NY |
| Zip Code | 11701-2955 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013427400 | Katya Cabrera | Licensed Practical Nurse | 8 Coolidge Ave, North Amityville, NY 11701 | 2017-10-11 |
| 1750800405 | Laura M Sabatino-jan | Nurse Practitioner | 65 S. Emerson Avenue, Amity Harbor, NY 11701 | 2017-09-13 |
| 1104355536 | Massapequa Center LLC | Skilled Nursing Facility | 101 Louden Ave., Amityville, NY 11701 | 2017-06-08 |
| 1588193874 | Allison Herzog | Specialist | 41 Terry Avenue, Amityville, NY 11701 | 2017-06-08 |
| 1962949677 | Sherlin Golbari | Physician Assistant | 317 Broadway Suite A, Amytyville, NY 11701 | 2017-01-20 |
| 1598129710 | Yoko Shiraiwa | Nurse Practitioner | 78 Ocean Avenue, Amityville, NY 11701 | 2016-04-13 |
| 1891158820 | Grace Ann Budde | Health Educator | 30 S Ireland Pl, Amityville, NY 11701 | 2016-03-29 |
| 1720445497 | Sabrina A Rahman | Pharmacist | 355 A Broadway, Amityville, NY 11701 | 2016-01-26 |
| 1902245335 | Darlene Marie Mccurty | Specialist | 125 Larsen Dr, Amityville, NY 11701 | 2013-06-19 |
| 1457613507 | Edria Parks | Specialist | 14 Wanser Pl, Amityville, NY 11701 | 2012-06-14 |
| Find all providers in zip 11701 | ||||
| Taxonomy Code | 133NN1002X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Nutritionist |
| Specialization | Nutrition, Education |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952908832 | Natalie Rae Palumbo | Nutritionist | 380 Hill St, Southampton, NY 11968-5327 | 2020-10-05 |
| 1912516972 | Sophia Aslanis | Nutritionist | 57 W 57th St Ste 900, New York, NY 10019-2813 | 2020-07-27 |
| 1225652357 | Amanda Dipietro | Nutritionist | 123 Hope St Apt 2l, Brooklyn, NY 11211-3984 | 2020-06-04 |
| 1366063232 | Nyc Naturally, Inc. | Nutritionist | 792 Route 35, Cross River, NY 10518-1118 | 2020-05-02 |
| 1740828847 | Evelina Sodt | Nutritionist | 65 Main St Fl 1, Warwick, NY 10990-1346 | 2019-12-19 |
| 1891332276 | Emily Wallis | Nutritionist | 315 Oakwood St, Rome, NY 13440-3806 | 2019-12-05 |
| 1639713969 | Ilana Lauer | Nutritionist | 759 Wilson Ct, Valley Stream, NY 11581-3531 | 2019-10-30 |
| 1558917591 | Helenica Yusuf | Nutritionist | 1 Brookdale Plaza 2acc- Q Rm 229-e, Brooklyn, NY 11212-3198 | 2019-08-15 |
| 1386101178 | Melissa Danielle O'shea | Nutritionist | 109 Manitou Trl, Kings Park, NY 11754-4550 | 2019-02-27 |
| 1518463496 | Aisha Brown | Nutritionist | 191 Lefferts Ave, Brooklyn, NY 11225-3418 | 2018-04-01 |
| Find all providers with the same taxonomy | ||||
| City | AMITYVILLE |
| Zip Code | 11701 |
Please comment or provide details below to improve the information on KELLY BROCK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.