Provider Demographics
NPI:1124621479
Name:KEELEY, MARIA ELENA
Entity type:Individual
Prefix:MS
First Name:MARIA
Middle Name:ELENA
Last Name:KEELEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 BOSTON RD
Mailing Address - Street 2:
Mailing Address - City:BILLERICA
Mailing Address - State:MA
Mailing Address - Zip Code:01821-5316
Mailing Address - Country:US
Mailing Address - Phone:978-667-7666
Mailing Address - Fax:978-670-9295
Practice Address - Street 1:700 BOSTON RD
Practice Address - Street 2:
Practice Address - City:BILLERICA
Practice Address - State:MA
Practice Address - Zip Code:01821-5316
Practice Address - Country:US
Practice Address - Phone:978-667-7666
Practice Address - Fax:978-670-9295
Is Sole Proprietor?:No
Enumeration Date:2020-11-19
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA21605183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist