DR. BRIAN KELLY (NPI# 1598053803) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598053803 |
| Entity Type | Individual |
| Full Name | DR. BRIAN KELLY |
| Credential | MD |
| Practice Address |
360 Tolland Tpke Suite 1a Manchester CT 06042-1771 |
| Mailing Address |
495 Hawley Ln Suite 2a Stratford CT 06614-1514 |
| Practice Telephone | 8605336551 |
| Mailing Telephone | 2032106340 |
| Enumeration Date | 2011-07-20 |
| Last Update Date | 2016-12-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
54058 | CT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 008062003 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649763368 | Brian Kelly | Dentist | 9134 Middlebelt Rd, Livonia, MI 48150-4035 | 2018-06-07 |
| 1801330436 | Brian Kelly | Social Worker | 240 Kensington Ln, Austin, TX 78737-4505 | 2016-12-16 |
| 1588093207 | Brian Kelly | Physical Therapist | 2801 Quebec St Nw Apt 548, Washington, DC 20008-6249 | 2013-11-04 |
| 1871810754 | Brian John Kelly | Psychiatry & Neurology | 47547 Coldspring Pl, Sterling, VA 20165-7446 | 2010-04-30 |
| 1073695953 | Brian M Kelly | Physical Medicine & Rehabilitation | 2850 S Industrial Hwy Ste 400, Ann Arbor, MI 48104-6796 | 2006-10-19 |
| 1396857892 | Brian G Kelly | Obstetrics & Gynecology | 25959 Kelly Road, Suite B, Roseville, MI 48066 | 2006-08-31 |
| 1376653451 | Brian Michael Kelly | Physical Therapist | 8228 Brentwood Industrial Dr, Saint Louis, MO 63144-2815 | 2006-08-30 |
| 1275550717 | Brian J. Kelly | Pediatrics | 11365 Dorsett Rd., Maryland Heights, MO 63043 | 2006-07-17 |
| 1811971666 | Brian P Kelly | Physical Therapist | 415 Crosslake Dr Ste B, Evansville, IN 47715 | 2005-12-05 |
| 1386286219 | Brian James Kelly | Pharmacist | 1600 Sw Archer Rd, Gainesville, FL 32610-3003 | 2019-10-11 |
| Street Address |
360 TOLLAND TPKE SUITE 1A |
| City | MANCHESTER |
| State | CT |
| Zip Code | 06042-1771 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265430219 | Lancelot P Morgan | Physician Assistant | 360 Tolland Tpke, 3c, Manchester, CT 06042-1771 | 2005-07-13 |
| 1205285814 | Vanessa Kristine Romero | Physician Assistant | 360 Tolland Tpke, Suite 1e, Manchester, CT 06042-1771 | 2016-06-06 |
| 1407265978 | Marissa Caye Carignan | Physician Assistant | 360 Tolland Tpke, Suite 1e, Manchester, CT 06042-1771 | 2014-08-08 |
| 1619393337 | Ptsma Inc | Clinic/Center | 360 Tolland Tpke, Suite 2e, Manchester, CT 06042-1771 | 2014-03-06 |
| 1578805164 | John James Griffith | Urology | 360 Tolland Tpke, Manchester, CT 06042 | 2013-03-21 |
| 1881930824 | Jessie R Mcmanus | Nurse Practitioner | 360 Tolland Tpke, Suite 2c, Manchester, CT 06042-1771 | 2012-12-19 |
| 1528240108 | Gastroenterology Associates of Manchester, LLC | Nurse Practitioner | 360 Tolland Tpke, Suite 2c, Manchester, CT 06042-1771 | 2007-12-05 |
| 1881884641 | Buckland Ear Nose & Throat LLC | Specialist/Technologist | 360 Tolland Tpke, Suiter 1e, Manchester, CT 06042-1771 | 2007-07-27 |
| 1679629489 | Monroe Heyward Rackow | Dentist | 360 Tolland Tpke, Suite 2a, Manchester, CT 06042-1771 | 2007-01-25 |
| 1003960360 | Ronald J Albert | Dentist | 360 Tolland Tpke, Suite 2b, Manchester, CT 06042-1771 | 2007-01-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275000960 | Nicole Berger | Behavioral Analyst | 199 Tudor Lane, Apartment E, Manchester, CT 06042 | 2018-10-31 |
| 1902336522 | Karen Scandura | Pharmacist | 260 North Main Street, Manchester, CT 06042 | 2017-06-15 |
| 1053727479 | Sph3enterprise, LLC | Dentist | 194 Buckland Hills Drive, Manchester, CT 06042 | 2014-07-07 |
| 1962657288 | Anthony Michael Gioscia | Optometrist | 344v Buckland Hills Dr, Manchester, CT 06042 | 2008-12-01 |
| 1467635714 | Linda Fernald Gates | Dietitian, Registered | 300 Parker St, Manchester, CT 06042 | 2007-12-10 |
| 1669513909 | Carlos Alfonso Gonzalez | Psychiatry & Neurology | 317 North Main Street, C/o Ccgc, Manchester, CT 06042 | 2007-02-09 |
| 1942350467 | Lise G. O'neill | Counselor | Manchester Memorial Hospital, 71 Haynes St, Manchester, CT 06042 | 2007-01-10 |
| 1558439398 | Jason Allen Sousa | Chiropractor | 1127 Tolland Turnpike, Suite 102, Manchester, CO 06042 | 2006-12-01 |
| 1245332444 | Sharon Soria | Dentist | 192 Main Street, Manchester, TN 06042 | 2006-09-01 |
| 1699732206 | First Choice Health Centers, Inc. | Clinic/Center | 150 N Main St Ste 240, Manchester, CT 06042 | 2006-04-27 |
| Find all providers in zip 06042 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518938281 | John Anthony Pietropaoli Jr. | Surgery | 260 Tolland Tpke, Suite 1a, Manchester, CT 06042-1764 | 2006-01-30 |
| 1174801682 | Jeffrey M Ranaudo | Surgery | 29 Haynes St, Unit D, Manchester, CT 06040-4139 | 2011-08-01 |
| 1235370057 | Catholic Medical Center | Surgery | 87 Mcgregor St, Suite 3100, Manchester, NH 03102-3765 | 2009-03-09 |
| 1225298532 | Chelsey N Lewis | Surgery | 185 Queen City Ave, Elliot General Surgical Specialists, Manchester, NH 03101-7121 | 2008-06-10 |
| 1841478500 | Elliot Professional Services | Surgery | 185 Queen City Ave, Elliot General Surgical Specialists, Manchester, NH 03101-7100 | 2008-02-05 |
| 1740338383 | Eric D. Adams | Surgery | 185 Queen City Ave, Manchester, NH 03101-7121 | 2007-01-08 |
| 1609869619 | Patricia Christine Furey | Surgery | 87 Mcgregor St, Suite 3100, Manchester, NH 03102-3731 | 2005-08-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336748953 | Usa Vascular Center of Connecticut Pllc | Surgery | 2284 Summer St, Stamford, CT 06905-4503 | 2020-10-23 |
| 1245839869 | Usa Vein Clinics of Connecticut Pllc | Surgery | 2284 Summer St Ste A, Stamford, CT 06905-4503 | 2020-10-23 |
| 1326385428 | Hossein L. Tehrani | Surgery | 49 East Hyerdale Drive, Goshen, CT 06756 | 2013-01-09 |
| 1922368810 | Megan Fritton Shue | Surgery | 540 Saybrook Rd Ste 210, Middletown, CT 06457-4759 | 2012-05-24 |
| 1932474053 | John E. Fenn | Surgery | 200 Leeder Hill Drive, #2603, Hamden, CT 06517 | 2012-03-22 |
| 1033366745 | Naiem Nassiri | Surgery | Yale University, 330 Cedar Street, Boardman Building 204, New Haven, CT 06510 | 2008-08-25 |
| 1407989569 | Christos G. Pappas | Surgery | 372 Danbury Rd Ste 220, Wilton, CT 06897-2523 | 2007-03-14 |
| 1477610913 | Stephen Marc Bauer | Surgery | 455 East Putnam Ave, Old Greenwich, CT 06870 | 2007-01-03 |
| 1114019098 | William Gething Crawford | Surgery | 21 Montauk Ave Ste 303, New London, CT 06320-4906 | 2006-09-29 |
| 1083713416 | Raul J. Guzman | Surgery | 330 Cedar St Bldg 204, New Haven, CT 06510 | 2006-09-22 |
| Find all providers with the same taxonomy | ||||
| City | MANCHESTER |
| Zip Code | 06042 |
Please comment or provide details below to improve the information on DR. BRIAN KELLY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.