Individual
PETER J KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
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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