Individual
MRS. KELLY MARIE CENNAME
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2211 GENESEE ST, UTICA, NY 13501-5930
(315) 801-8567
Mailing address
2209 GENESEE ST., BUSINESS OFFICE, UTICA, NY 13501-5930
(315) 801-4238
(315) 801-8391
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
06/01/2011
Last updated
11/19/2020
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