National Provider Identifier

Kelly Lynn Manganello, P.A.

Kelly Lynn Manganello, P.A. is listed in the NPPES registry with a primary specialty of Physician Assistant in Williamsville, NY and a listed phone number of (716) 831-2600.

NPI 1669638953Williamsville, NYPhysician Assistant

Profile Overview

NPI
1669638953
Provider Type
Individual
Primary Specialty
Physician Assistant
Enumeration Date
August 06, 2008
Last Updated
May 11, 2016

Practice Location

  • 297 Spindrift Dr
  • Williamsville, NY 14221-7894

Phone: (716) 831-2600

Specialties

  • Physician Assistant (363A00000X)
Full Record
NPI
1669638953
Entity Type
Individual
Last Name
Manganello
First Name
Kelly
Middle Name
Lynn
Credential
P.A.
Provider Other Last Name
Manno
Provider Other First Name
Kelly
Provider Other Middle Name
Lynn
Provider Other Last Name Type Code
5
Mailing Street Address
297 Spindrift Dr
Mailing City
Williamsville
Mailing State
NY
Mailing ZIP Code
14221-7894
Mailing Country
US
Mailing Phone
(716) 831-2600
Mailing Fax
(716) 831-2601
Practice Street Address
297 Spindrift Dr
Practice City
Williamsville
Practice State
NY
Practice ZIP Code
14221-7894
Practice Country
US
Practice Phone
(716) 831-2600
Practice Fax
(716) 831-2601
Enumeration Date
August 06, 2008
Last Updated
May 11, 2016
Sex
Female
Sole Proprietor
No
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Physician Assistant (363A00000X)