Kelley, Robert Long

Kelley, Robert Long is an individual health care provider with primary practice located at 20 Hope Ave Suite 201 , Waltham MA 20453. He recently has only one registered license in Allopathic & Osteopathic Physicians / Addiction Psychiatry, which is considered as his primary health care specialty. Kelley, Robert Long can be contacted via phone (781) 891-4909.

Contact Information

Primary practice address
20 Hope Ave Suite 201 Waltham MA 20453
Phone: (781) 891-4909
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Addiction Psychiatry 2084P0802X 24754 Massachusetts

Profile Details

NPI number 1093876609
LBN Legal business name Kelley, Robert Long
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 13th, 2006
Last updated Feb 10th, 2016 - about 8 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 1093876609 NPPES
Massachusetts MEDICAID MK0074803AR

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