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
Phone: (860) 674-1824
Fax:
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1013976703 | NPPES |
| Connecticut | MEDICAID | 00424493500 | |
| Connecticut | Other | 3623042 |
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