Individual
GERALDINE K KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6300 POWERS RD, ORCHARD PARK, NY 14127-3216
(716) 667-3222
(716) 667-3213
Mailing address
6300 POWERS RD, ORCHARD PARK, NY 14127-3216
(716) 667-3222
(716) 667-3213
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
131207
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000508144006
BLUE CROSS OF WNY
NY
01
—
010125493
RAILROAD MEDICARE
NY
01
—
0406891
INDEPENDENT HEALTH
NY
01
—
044122000033
FIDELIS
NY
Enumeration date
07/24/2006
Last updated
12/07/2011
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