National Provider Identifier

Kelley A Clark, PA-C

Kelley A Clark, PA-C is listed in the NPPES registry with a primary specialty of Physician Assistant in Boston, MA and a listed phone number of (617) 638-8992.

NPI 1194004069Boston, MAPhysician Assistant

Source: public NPPES record, last updated February 04, 2015. This profile is informational and is not medical advice, a quality rating, or a provider recommendation.

Profile Overview

NPI
1194004069
Provider Type
Individual
Primary Specialty
Physician Assistant
Enumeration Date
August 10, 2011
Last Updated
February 04, 2015

Practice Location

  • 725 Albany St
  • Suite 7C
  • Boston, MA 02118-2526

Phone: (617) 638-8992

Mailing Address

  • 720 Harrison Ave
  • Dob 503
  • Boston, MA 02118

Specialties

  • Physician Assistant (363A00000X)

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Biography

Kelley A. Clark, PA-C, is a physician assistant at Boston Medical Center in Boston. Public Medicare-derived profiles associate her with Boston University Neurosurgical Associates and list Boston Medical Center as a hospital affiliation, reflecting work in an academic neurosurgery practice setting.

Full Record
NPI
1194004069
Entity Type
Individual
Last Name
Clark
First Name
Kelley
Middle Name
A
Credential
PA-C
Mailing Street Address
720 Harrison Ave
Mailing Address Line 2
Dob 503
Mailing City
Boston
Mailing State
MA
Mailing ZIP Code
02118
Mailing Country
US
Practice Street Address
725 Albany St
Practice Address Line 2
Suite 7C
Practice City
Boston
Practice State
MA
Practice ZIP Code
02118-2526
Practice Country
US
Practice Phone
(617) 638-8992
Practice Fax
(617) 638-8979
Enumeration Date
August 10, 2011
Last Updated
February 04, 2015
Sex
Female
Sole Proprietor
No
Taxonomies
Physician Assistant (363A00000X)