Individual
JEAN C. KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1353 DORCHESTER AVE, DORCHESTER, MA 02122-2932
(617) 740-2277
Mailing address
1353 DORCHESTER AVE, DORCHESTER, MA 02122-2932
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
72752
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3070123
—
MA
Enumeration date
03/24/2006
Last updated
01/19/2017
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