Kelley, Samuel K

Kelley, Samuel K is an individual health care provider with primary practice located at 151 Mystic Ave Ste 6 C/O Judy Donnelly - Dcs Mental Healt, Medford MA 02155-4632. He recently has only one registered license in Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry, which is considered as his primary health care specialty. Kelley, Samuel K can be contacted via phone (617) 877-8292.

Contact Information

Primary practice address
151 Mystic Ave Ste 6 C/O Judy Donnelly - Dcs Mental Healt Medford MA 02155-4632
Phone: (617) 877-8292
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X 72427 Massachusetts

Profile Details

NPI number 1154368199
LBN Legal business name Kelley, Samuel K
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 31st, 2006
Last updated Jul 25th, 2013 - about 12 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 1154368199 NPPES
Massachusetts Other 1154368199 NPI

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