Kelly, Mary Alice

Kelly, Mary Alice is an individual health care provider with primary practice located at 1900 Ridge Rd Ste 130, West Seneca NY 14224-3332. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Kelly, Mary Alice can be contacted via phone (716) 675-0707.

Contact Information

Primary practice address
1900 Ridge Rd Ste 130 West Seneca NY 14224-3332
Phone: (716) 675-0707
Fax: (716) 961-3706
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 1568631 New York

Profile Details

NPI number 1053361816
LBN Legal business name Kelly, Mary Alice
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 11th, 2006
Last updated Oct 19th, 2012 - about 13 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 1053361816 NPPES
Other 0401537 IHA
Other 00010089201 IHA
Other 000500738001 IHA

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