Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kellianne Tulley

Individual provider Physician Assistant · NPI 1760842637

Kellianne Tulley is a Physician Assistant in Merrick, New York. Qualified in 2015, 11 years ago. Practices with New York University, a 5,884-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
11
Licensed in
NY
In the registry since
2016
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Practice location Address checks out

21 Woodbine Ave
Merrick, NY 11566-3130
Phone: (516) 663-8963
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 19479 (NY)

Record details

NPI number1760842637
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMarch 4, 2016
Last updated in NPPESJune 28, 2023
Mailing address21 Woodbine Ave, Merrick, NY 11566-3130

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice New York University — 5884 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Merrick