Kelly, Marybeth S

Kelly, Marybeth S is an individual health care provider with primary practice located at 75 Springfield Rd Suite 1 Family Medicine Assoc, Westfield MA 01085. 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. Kelly, Marybeth S can be contacted via phone (413) 562-5173.

Contact Information

Primary practice address
75 Springfield Rd Suite 1 Family Medicine Assoc Westfield MA 01085
Phone: (413) 562-5173
Fax: (413) 562-1716
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 1150 Massachusetts

Profile Details

NPI number 1235139130
LBN Legal business name Kelly, Marybeth S
Credentials PAC
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 21st, 2005
Last updated Jan 3rd, 2008 - about 16 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 1235139130 NPPES
Other 011500 CONNECTICARE OF MA
Other 21237210422 CONNECTICARE OF MA

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