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Organization

KELLY AND VELAZQUEZ EYE CENTER PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
PETER J KELLY (PRESIDENT)
(413) 284-4481
Entity
Organization

Contact information

Practice address
1504 N MAIN ST, PALMER, MA 01069-1215
(413) 283-3511
(413) 283-5396
Mailing address
1504 N MAIN ST, PALMER, MA 01069-1215
(413) 283-3511
(413) 283-5396

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
41270
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
13541
HNE
01
14520
FALLON HEALTHPLAN
MA
01
735819
TUFTS HEALTHPLAN
MA
05
9739319
MA
01
C13251
RAILROAD MEDICARE
MA
01
M13919
BCBS
MA
01
W20291
BCBS ANCILLARY
MA
Enumeration date
08/10/2005
Last updated
12/09/2019
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