National Provider Identifier
Mary Alice Kelly, MD
Mary Alice Kelly, MD is listed in the NPPES registry with a primary specialty of Internal Medicine Physician in West Seneca, NY and a listed phone number of (716) 675-0707.
Profile Overview
- NPI
- 1053361816
- Provider Type
- Individual
- Primary Specialty
- Internal Medicine Physician
- Enumeration Date
- May 11, 2006
- Last Updated
- October 19, 2012
Practice Location
- 1900 Ridge RD
- Ste 130
- West Seneca, NY 14224-3332
Phone: (716) 675-0707
Mailing Address
- 1900 Ridge RD
- Ste130
- West Seneca, NY 14224-3332
Specialties
- Internal Medicine Physician (207R00000X)
Full Record
- NPI
- 1053361816
- Entity Type
- Individual
- Last Name
- Kelly
- First Name
- Mary
- Middle Name
- Alice
- Name Prefix
- Dr.
- Credential
- MD
- Mailing Street Address
- 1900 Ridge RD
- Mailing Address Line 2
- Ste130
- Mailing City
- West Seneca
- Mailing State
- NY
- Mailing ZIP Code
- 14224-3332
- Mailing Country
- US
- Mailing Phone
- (716) 675-0707
- Mailing Fax
- (716) 961-3706
- Practice Street Address
- 1900 Ridge RD
- Practice Address Line 2
- Ste 130
- Practice City
- West Seneca
- Practice State
- NY
- Practice ZIP Code
- 14224-3332
- Practice Country
- US
- Practice Phone
- (716) 675-0707
- Practice Fax
- (716) 961-3706
- Enumeration Date
- May 11, 2006
- Last Updated
- October 19, 2012
- Sex
- Female
- Sole Proprietor
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Internal Medicine Physician (207R00000X)
- Other Identifiers
- 0401537 (Iha), 00010089201 (Univera), 000500738001 (BCBS)