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MS. KELLY TERESA MARVULLO
NPI 1699022830
Specialist in Lake Ronkonkoma, NY

Active since August 07, 2012
43 DORCHESTER ROAD, LAKE RONKONKOMA, NY 11779(631) 278-2556 Get Directions Write a Review

NPPES record last updated: August 7, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Ms. Kelly Teresa Marvullo NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. KELLY TERESA MARVULLO (NPI 1699022830) is an individual specialist in Lake Ronkonkoma, New York, licensed in New York (1135283) and active in the NPI registry since August 2012.

NPPES Registry Identity

NPI1699022830
Entity TypeIndividualFemale
Primary Taxonomy174400000X
Provider Legal NameMS. KELLY TERESA MARVULLO
Location Address43 DORCHESTER ROADLake Ronkonkoma, NY 11779-1616
Mailing Address43 Dorchester RdLake Ronkonkoma, NY 11779-1616 · (631) 278-2556
Phone(631) 278-2556
Sole ProprietorNo
Enumeration DateAugust 7, 2012
✔ NPI 1699022830 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in NY · 1135283
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.
43 DORCHESTER ROAD, Lake Ronkonkoma, NY 11779
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kelly Marvullo's NPI number?

The NPI number for Kelly Marvullo is 1699022830. It was assigned to this individual provider in the NPPES registry on August 7, 2012.

Where is Kelly Marvullo located?

Kelly Marvullo practices at 43 Dorchester Road, Lake Ronkonkoma, NY 11779. The listed phone number is (631) 278-2556.

What is Kelly Marvullo's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

When was this NPI record last updated?

The NPPES record for Kelly Marvullo was last updated on August 7, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.