Kelly Ann Antimisiaris
Kelly Ann Antimisiaris is a Nurse Practitioner in Massapequa, New York. Qualified in 2023, 3 years ago. Practices with North Shore-Lij Medical PC, a 6,350-clinician group and accepts Medicare assignment. Licensed in New York.
- Years since qualifying
- 3
- Licensed in
- NY
- In the registry since
- 2023
Practice location Address checks out
5550 Merrick RdMassapequa, NY 11758-6238
Phone: (631) 773-1096
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Psychiatric/Mental Health Nurse Practitioner (primary) | Taxonomy 363LP0808X · Licence 405343 (NY) |
|---|
Record details
| NPI number | 1265213797 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | No |
| NPI enumerated | October 10, 2023 |
| Last updated in NPPES | October 10, 2023 |
| Certification date | October 10, 2023 |
Medicare enrollment
| Medicare specialty | NURSE PRACTITIONER |
|---|---|
| Medical school | OTHER |
| Graduated | 2023 (3 years in practice) |
| Group practice | North Shore-Lij Medical Pc — 6350 clinicians |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
Other providers in Massapequa
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Jessica Denicola, PMHNP-BC
5550 Merrick Rd, Massapequa, NY 11758-6238 · (516) 361-3067
-
Mr. James Gonedes Jr.
293 N Park Dr, Massapequa, NY 11758-2131 · (732) 670-9799
-
Tatyana Goykhberg, PMHNP
4190 Sunrise Hwy Ste A, Massapequa, NY 11758 · (516) 765-7799
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Great Water Land Services Nurse Practitioner in Psychiatry PLLC
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