Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080N0001X | Neonatal-Perinatal Doctor | 246762 | NY |
Y | 2080N0001X | Neonatal-Perinatal Doctor | 55918 | CT |
NPI | 1053584086 |
---|---|
Provider Name | Dr. Kelly Eleanor Moulton Gullotta |
First Address | Rochester, NY 14642-0001 |
Second Address | Rochester, NY 14642-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2008 |
Last Update Date | 16/01/2017 |