Individual
DR. AILEEN T KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9509 PARK ST, MANASSAS, VA 20110-4311
(703) 392-1470
Mailing address
9509 PARK ST, MANASSAS, VA 20110-4311
(703) 392-1470
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0101045784
VA
Other
Enumeration date
05/17/2024
Last updated
05/17/2024
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