Individual
MR. RUSSELL AARON KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
451 ANDOVER ST STE 206A, NORTH ANDOVER, MA 01845-5044
(978) 662-1002
(978) 767-4757
Mailing address
10 LAKEWOOD RD, LYNNFIELD, MA 01940-1945
(817) 249-6671
(978) 767-4757
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1762
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0009706
MEDICARE PTAN
MA
05
—
111477
—
MA
Enumeration date
09/15/2006
Last updated
08/25/2025
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us