Provider Demographics
NPI:1447249370
Name:CONLAN, KELLI MAYFARTH (MS, CGC)
Entity type:Individual
Prefix:MS
First Name:KELLI
Middle Name:MAYFARTH
Last Name:CONLAN
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 READE PL
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-3947
Mailing Address - Country:US
Mailing Address - Phone:845-483-6667
Mailing Address - Fax:845-790-3128
Practice Address - Street 1:45 READE PL
Practice Address - Street 2:DYSON CENTER, 2ND FL
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-3947
Practice Address - Country:US
Practice Address - Phone:845-483-6641
Practice Address - Fax:845-483-6407
Is Sole Proprietor?:No
Enumeration Date:2005-10-13
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS