Individual
MS. GINA KELLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
850 N MAIN STREET EXT # 2, WALLINGFORD, CT 06492-2400
(203) 886-0036
Mailing address
65 QUARRY VILLAGE RD, CHESHIRE, CT 06410-2062
(413) 454-8706
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
6510
CT
Other
Enumeration date
03/13/2024
Last updated
03/13/2024
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