Individual
SHELLY-ANN BENESIA KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
UCONN MEDICAL GROUP, 263 FARMINGTON AVE, FARMINGTON, CT 06030-0001
(860) 679-8080
(860) 679-1430
Mailing address
UCONN MEDICAL GROUP, 263 FARMINGTON AVE, FARMINGTON, CT 06030-0001
(860) 679-8080
(860) 679-1430
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
363AS0400X
Surgical Physician Assistant
002718
CT
Other
Enumeration date
10/10/2011
Last updated
06/02/2016
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