National Provider Identifier
Mallory Lynn Kelly, RPA-C
Mallory Lynn Kelly, RPA-C is listed in the NPPES registry with a primary specialty of Physician Assistant in West Seneca, NY and a listed phone number of (716) 675-7693.
Profile Overview
- NPI
- 1730414111
- Provider Type
- Individual
- Primary Specialty
- Physician Assistant
- Enumeration Date
- October 02, 2009
- Last Updated
- October 08, 2021
Practice Location
- 290 Center RD
- West Seneca, NY 14224-1945
Phone: (716) 675-7693
Specialties
- Physician Assistant (363A00000X)
Full Record
- NPI
- 1730414111
- Entity Type
- Individual
- Last Name
- Kelly
- First Name
- Mallory
- Middle Name
- Lynn
- Name Prefix
- Mrs.
- Credential
- RPA-C
- Mailing Street Address
- 290 Center RD
- Mailing City
- West Seneca
- Mailing State
- NY
- Mailing ZIP Code
- 14224-1945
- Mailing Country
- US
- Mailing Phone
- (716) 675-7693
- Mailing Fax
- (855) 714-1253
- Practice Street Address
- 290 Center RD
- Practice City
- West Seneca
- Practice State
- NY
- Practice ZIP Code
- 14224-1945
- Practice Country
- US
- Practice Phone
- (716) 675-7693
- Practice Fax
- (855) 714-1253
- Enumeration Date
- October 02, 2009
- Last Updated
- October 08, 2021
- Sex
- Female
- Sole Proprietor
- Yes
- Certification Date
- October 07, 2021
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Physician Assistant (363A00000X)