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Individual

PETER J KELLY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1504 N MAIN ST, PALMER, MA 01069-1215
(413) 283-3511
(413) 283-5396
Mailing address
1504 N MAIN ST, PALMER, MA 01069-1215
(413) 283-3511
(413) 283-5396

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
41270
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0000000020721
HEALTHNET
01
0025915
AETNA
01
042744585
COSTCARE PPO
01
0598171-003
CIGNA
01
150714
HARVARD PILGRIM
01
1582315
FIRST HEALTH
01
350270
CMHC
01
744585
CONNECTICARE
05
9739319
MA
01
H15034
BCBS
01
MA1270
EYEMED
01
PAL: 39699
DAVIS VISION
01
S030683
CHAMPUS
Enumeration date
08/10/2005
Last updated
06/17/2019
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