Individual
DR. KELLY TECTOR MIGLIERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1493 CAMBRIDGE ST, CAMBRIDGE, MA 02139-1047
(617) 665-2555
Mailing address
1493 CAMBRIDGE ST, CAMBRIDGE, MA 02139-1047
(617) 665-2225
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
215039
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1740402460
BLUE CROSS
—
Enumeration date
05/03/2007
Last updated
02/02/2012
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