Individual
KELLY BENABOU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3300 MAIN STREET, 4TH FL, SUITE D, SPRINGFIELD, MA 01107-1112
(413) 794-7045
(413) 794-7345
Mailing address
280 CHESTNUT STREET, 2ND FLOOR, SPRINGFIELD, MA 01199-1001
(413) 794-5700
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
287530
MA
390200000X
Student in an Organized Health Care Education/Training Program
62422
CT
Other
Enumeration date
06/23/2015
Last updated
09/01/2021
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