Kelliher, Timothy Raymond

Kelliher, Timothy Raymond is an individual health care provider with primary practice located at 83 Herrick St Ste 1001 , Beverly MA 01915-2753. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as his primary health care specialty. Kelliher, Timothy Raymond can be contacted via phone (978) 922-2226.

Contact Information

Primary practice address
83 Herrick St Ste 1001 Beverly MA 01915-2753
Fax: (978) 922-2269
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurology 2084N0400X 75613 Massachusetts

Profile Details

NPI number 1043314198
LBN Legal business name Kelliher, Timothy Raymond
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 11th, 2006
Last updated May 28th, 2020 - about 6 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 1043314198 NPPES
Massachusetts MEDICAID A20168
Massachusetts Other DM9771
Massachusetts Other J31266
Massachusetts Other 722666
Massachusetts Other 814325

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