Individual
DR. RAYMOND J KELLEHER III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD PHD
Contact information
Practice address
15 PARKMAN STREET, NEUROLOGY ASSOCIATES WAC 835, BOSTON, MA 02114-3117
(617) 726-1728
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 726-1728
(617) 726-4101
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
152943
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3191915
—
MA
01
—
750080
TUFTS HEALTH PLAN
MA
01
—
J19901
BCBS MA
MA
Enumeration date
07/30/2006
Last updated
08/10/2012
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