Kelley, Mary Michael

Kelley, Mary Michael is an individual health care provider with primary practice located at 396 Broadway , Kingston NY 12401-4626. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Kelley, Mary Michael can be contacted via phone (845) 334-2890.

Contact Information

Primary practice address
396 Broadway Kingston NY 12401-4626
Phone: (845) 334-2890
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 007123 New York

Profile Details

NPI number 1689608275
LBN Legal business name Kelley, Mary Michael
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 10th, 2006
Last updated Jul 12th, 2007 - about 18 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1689608275 NPPES
New York Other 364664 MVP

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