National Provider Identifier
Kelly Squire
Kelly Squire is listed in the NPPES registry with a primary specialty of Specialist in Medina, NY and a listed phone number of (585) 478-2721.
Profile Overview
- NPI
- 1154672731
- Provider Type
- Individual
- Primary Specialty
- Specialist
- Enumeration Date
- September 24, 2012
- Last Updated
- September 24, 2012
Practice Location
- 1024 Park Ave
- Medina, NY 14103-1030
Phone: (585) 478-2721
Specialties
- Specialist (174400000X)
Full Record
- NPI
- 1154672731
- Entity Type
- Individual
- Last Name
- Squire
- First Name
- Kelly
- Mailing Street Address
- 1024 Park Ave
- Mailing City
- Medina
- Mailing State
- NY
- Mailing ZIP Code
- 14103-1030
- Mailing Country
- US
- Mailing Phone
- (585) 478-2721
- Practice Street Address
- 1024 Park Ave
- Practice City
- Medina
- Practice State
- NY
- Practice ZIP Code
- 14103-1030
- Practice Country
- US
- Practice Phone
- (585) 478-2721
- Enumeration Date
- September 24, 2012
- Last Updated
- September 24, 2012
- Sex
- Female
- Sole Proprietor
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Specialist (174400000X)