Massucci, Kelly A

Massucci, Kelly A is an individual health care provider with primary practice located at 270 Farmington Ave Suite 126, Farmington CT 06032-1909. She recently has only one registered license in Other Service Providers / Specialist, which is considered as her primary health care specialty. Massucci, Kelly A can be contacted via phone (860) 674-1824.

Contact Information

Primary practice address
270 Farmington Ave Suite 126 Farmington CT 06032-1909
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 002268 Connecticut

Profile Details

NPI number 1013976703
LBN Legal business name Massucci, Kelly A
Credentials M.ED. OTR/L
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 21st, 2006
Last updated Jul 9th, 2007 - about 19 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 1013976703 NPPES
Connecticut MEDICAID 00424493500
Connecticut Other 3623042

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