National Provider Identifier

Maureen C Kelly, PA

Maureen C Kelly, PA is listed in the NPPES registry with a primary specialty of Medical Physician Assistant in Lockport, NY and a listed phone number of (716) 342-3026.

NPI 1881664902Lockport, NYMedical Physician Assistant

Profile Overview

NPI
1881664902
Provider Type
Individual
Primary Specialty
Medical Physician Assistant
Enumeration Date
January 23, 2006
Last Updated
January 30, 2026

Practice Location

  • 6001 Shimer Dr
  • Lockport, NY 14094-6412

Phone: (716) 342-3026

Specialties

  • Medical Physician Assistant (363AM0700X)
  • Medical Physician Assistant (363AM0700X)
  • Physician Assistant (363A00000X)
Full Record
NPI
1881664902
Entity Type
Individual
Last Name
Kelly
First Name
Maureen
Middle Name
C
Name Prefix
MS.
Credential
PA
Mailing Street Address
6001 Shimer Dr
Mailing City
Lockport
Mailing State
NY
Mailing ZIP Code
14094-6412
Mailing Country
US
Mailing Phone
(716) 342-3026
Mailing Fax
(716) 342-3027
Practice Street Address
6001 Shimer Dr
Practice City
Lockport
Practice State
NY
Practice ZIP Code
14094-6412
Practice Country
US
Practice Phone
(716) 342-3026
Practice Fax
(716) 342-3027
Enumeration Date
January 23, 2006
Last Updated
January 30, 2026
Sex
Female
Sole Proprietor
No
Certification Date
January 30, 2026
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Medical Physician Assistant (363AM0700X), Medical Physician Assistant (363AM0700X), Physician Assistant (363A00000X)
Other Identifiers
08307375 (NY), 004245272 (CT), 290001363CT02 (CT, Anthem BCBS)