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1447300702
MARTIN J. KELLY
FARMINGTON, CT
NPI
1447300702
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: CT 000979)
Enumeration Date
2007-01-11
Last Update Date
2023-03-07
Business Address
-- MARTIN J. KELLY PA
263 FARMINGTON AVE PROVIDER ENROLLMENT
FARMINGTON, CT 06030-2212
Phone number: 860-679-7503
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Mailing Address
-- MARTIN J. KELLY PA
263 FARMINGTON AVE PROVIDER ENROLLMENT
FARMINGTON, CT 06030-2212
Phone number: 860-679-7503
Copy
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