Individual
DR. GEORGIA ANN KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
100 BROADWAY, NORTH HAVEN, CT 06473-2365
(203) 234-1891
(203) 234-2678
Mailing address
100 BROADWAY, NORTH HAVEN, CT 06473-2365
(203) 234-1891
(203) 234-2678
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
034092
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001340926
—
CT
01
—
010034092CT01
ANTHEM BCBS
CT
01
—
01034092
CIGNA
CT
01
—
0488063
AETNA
CT
01
—
061535742
UNITED HEALTHCARE
CT
01
—
0Q1536
HEALTHNET
CT
01
—
110180478
RAILROAD MEDICARE
CT
01
—
340920
CTCARE
CT
01
—
P499703
OXFORD
CT
Enumeration date
06/28/2006
Last updated
09/11/2008
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