Provider Demographics
NPI:1962172437
Name:PAOLINI, KELLEY MARIE (MS,LPN, IHP)
Entity type:Individual
Prefix:
First Name:KELLEY
Middle Name:MARIE
Last Name:PAOLINI
Suffix:
Gender:F
Credentials:MS,LPN, IHP
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Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5949 CAMP RD # 1010
Mailing Address - Street 2:
Mailing Address - City:HAMBURG
Mailing Address - State:NY
Mailing Address - Zip Code:14075-4425
Mailing Address - Country:US
Mailing Address - Phone:716-481-1959
Mailing Address - Fax:
Practice Address - Street 1:4768 MOSEY LN
Practice Address - Street 2:
Practice Address - City:BLASDELL
Practice Address - State:NY
Practice Address - Zip Code:14219-2970
Practice Address - Country:US
Practice Address - Phone:716-481-1959
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-16
Last Update Date:2021-09-16
Deactivation Date:
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