KELLY FELLOWS (NPI# 1154708873) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154708873 |
| Entity Type | Individual |
| Full Name | KELLY FELLOWS |
| Credential | M.D. |
| Practice Address |
30 Shelburne Rd Stamford CT 06902-3628 |
| Mailing Address |
1211 24th St Anacortes WA 98221-2562 |
| Practice Telephone | 2032767581 |
| Mailing Telephone | 3602933101 |
| Enumeration Date | 2015-05-01 |
| Last Update Date | 2019-04-22 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | MD60931695 | WA | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
30 SHELBURNE RD |
| City | STAMFORD |
| State | CT |
| Zip Code | 06902-3628 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558351759 | Bo Xu | Pathology | 30 Shelburne Rd, Stamford, CT 06902-3628 | 2005-10-27 |
| 1518311984 | Pankil Desai | Student in an Organized Health Care Education/Training Program | 30 Shelburne Rd, Stamford, CT 06902-3628 | 2016-04-21 |
| 1033571229 | Rami Al-aref | Surgery | 30 Shelburne Rd, Stamford, CT 06902-3628 | 2016-03-25 |
| 1508228198 | Borna Dabiri | Student in an Organized Health Care Education/Training Program | 30 Shelburne Rd, Stamford, CT 06902-3628 | 2016-03-23 |
| 1073971735 | Tyler Ferraro | Physician Assistant | 30 Shelburne Rd, Stamford, CT 06902-3628 | 2016-02-09 |
| 1376901256 | Vanie Mangal | Physician Assistant | 30 Shelburne Rd, Stamford, CT 06902-3628 | 2016-02-05 |
| 1487023115 | Cynthia Degracia | Spec/Tech, Pathology | 30 Shelburne Rd, Stamford, CT 06902-3628 | 2015-09-23 |
| 1932595360 | Somera Chaudhry | Internal Medicine | 30 Shelburne Rd, Dept of Medicine, Stamford, CT 06902-3628 | 2015-04-13 |
| 1043606486 | Chao Guo | Internal Medicine | 30 Shelburne Rd, Dept of Medicine, Stamford, CT 06902 | 2015-04-13 |
| 1043606320 | Madhuri Tirumandas | Student in an Organized Health Care Education/Training Program | 30 Shelburne Rd, Dept of Medicine, Stamford, CT 06902-3628 | 2015-04-13 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861043242 | Palak Bhambri | Pharmacist | 537 Canal Street, Stamford, CT 06902 | 2019-09-26 |
| 1730654815 | Brenice Duroseau | Nurse Practitioner | 292 Long Ridge Rd Ste 202, Stamford, CT 06902 | 2018-10-04 |
| 1447732862 | Ngoc Lam | Pharmacist | 1990 West Main Street, Stamford, CT 06902 | 2018-09-01 |
| 1336627264 | Margaret F Gorelick | Nurse Practitioner | Stamford Health, One Hospital Plaza, Stamford, CT 06902 | 2018-08-02 |
| 1174053425 | Ashley Marie Santana | Social Worker | 110 Commons Park N Apt 1158, Stamford, CT 06902 | 2017-06-19 |
| 1578090395 | Anas Al-sabbagh | Dentist | 1 Strawberry Hill Court Suite L7 Stamford, Connecticut, Stamford, CT 06902 | 2017-05-11 |
| 1154862936 | Hillary Rubin | Psychologist | 44 Commerce Avenue, Stamford, CT 06902 | 2017-03-14 |
| 1801332135 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1 Hospital Plz Ste G122, Stamford, CT 06902 | 2017-01-10 |
| 1932563277 | Mary Hurtadodemendoza | Pharmacist | 59 Courtland Ave 2m, Stamford, CT 06902 | 2016-04-13 |
| 1235592247 | Advanced Therapy and Performance LLC | Physical Medicine & Rehabilitation | 75 Selleck Street, Stamford, CT 06902 | 2016-03-29 |
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| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578906277 | Catherine Marie Wilkes | Obstetrics & Gynecology | 190 W Broad St Ste G401, Stamford, CT 06902-3633 | 2013-04-11 |
| 1699010439 | Arthur Philip Mostel | Obstetrics & Gynecology | 300 Quarry Rd, Stamford, CT 06903-5003 | 2012-12-05 |
| 1659686863 | Heghine Zalinyan | Obstetrics & Gynecology | 205 Bayberrie Dr, Stamford, CT 06902-2002 | 2010-08-11 |
| 1023101292 | Vito Ferrucci | Obstetrics & Gynecology | 833 Summer St, Suite 1b, Stamford, CT 06901 | 2006-10-02 |
| 1326142415 | David B Weinstein | Obstetrics & Gynecology | 190 West Broad St, Whittingham Pavilion #g401, Stamford, CT 06902-3633 | 2006-09-11 |
| 1043669955 | Elana Peck | Obstetrics & Gynecology | 1351 Washington Boulevard, 4th Floor - Ob/gyn, Stamford, CT 06902-3609 | 2016-06-10 |
| 1700263316 | Kiger Lau | Obstetrics & Gynecology | 1 Hospital Plz, Stamford, CT 06902-3602 | 2015-05-04 |
| 1093101826 | Lindsey Michel | Obstetrics & Gynecology | 1 Hospital Plz, Stamford, CT 06902 | 2015-04-08 |
| 1366840498 | Chi-son Kim | Obstetrics & Gynecology | 1 Hospital Plz, Stamford, CT 06902-3602 | 2014-12-05 |
| 1467890848 | Kezia Spence | Obstetrics & Gynecology | 30 Shelburne Rd, Whittingham Pavilion, Stamford, CT 06902-3628 | 2013-06-07 |
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| 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.