Kelley, Georgia Ann
Kelley, Georgia Ann is an individual health care provider with primary practice located at 100 Broadway , North Haven CT 06473-2365. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Kelley, Georgia Ann can be contacted via phone (203) 234-1891.Contact Information
Primary practice address
100 Broadway
North Haven CT 06473-2365
Phone: (203) 234-1891
Fax: (203) 234-2678
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 034092 | Connecticut |
Profile Details
| NPI number | 1013945211 |
|---|---|
| LBN Legal business name | Kelley, Georgia Ann |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 28th, 2006 |
| Last updated | Sep 11th, 2008 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1013945211 | NPPES |
| Connecticut | Other | 0488063 | AETNA |
| Connecticut | Other | 010034092CT01 | AETNA |
| Connecticut | Other | 061535742 | AETNA |
| Connecticut | Other | P499703 | AETNA |
| Connecticut | Other | 01034092 | AETNA |
| Connecticut | MEDICAID | 001340926 | AETNA |
| Connecticut | Other | 110180478 | AETNA |
| Connecticut | Other | 340920 | AETNA |
| Connecticut | Other | 0Q1536 | AETNA |
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