MRS. BRENDA LEAIRD KELLY (NPI# 1295760619) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1295760619 |
Entity Type | Individual |
Full Name | MRS. BRENDA LEAIRD KELLY |
Other Name | BRENDA LEAIRD BRIE |
Credential | PA |
Practice Address |
899 Main Street William E Mosher Health Center Buffalo NY 14203 |
Mailing Address |
800 Carter Street Rochester NY 14621 |
Practice Telephone | 7168782700 |
Practice Fax Number | 7165045544 |
Mailing Telephone | 5853394793 |
Mailing Fax Number | 5853364845 |
Enumeration Date | 2006-07-12 |
Last Update Date | 2007-07-08 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
005508 | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NY | PREFERRED CARE | 180049FL | 01 |
NY | FIDELIS CARE | 040909000003 | 01 |
NY | IHA | 9513175 | 01 |
NY | BCBS OF WNY | 000570209005 | 01 |
NY | CAQH | 11563513 | 01 |
NY | MEDICARE RAILROAD | P00338492 | 01 |
Street Address |
899 MAIN STREET WILLIAM E MOSHER HEALTH CENTER |
City | BUFFALO |
State | NY |
Zip Code | 14203 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1265535751 | Paul D Bruschini | Physical Therapist | 899 Main Street, William E Mosher Health Center, Buffalo, NY 14203 | 2006-09-07 |
1407958309 | Rathini C Packianathan | Dentist | 899 Main Street, Buffalo, NY 14203 | 2006-09-01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1912514902 | Valerie Anne Conley | Counselor | 475 Elllicott St., Buffalo, NY 14203 | 2020-09-24 |
1457975674 | Qing Ma | Pharmacist | Nys Center of Excellence In Bioinformatics and Life Sci, 701 Ellicott Street, Buffalo, NY 14203 | 2020-06-03 |
1265056659 | Elizabeth Nicole Mancuso | Student in an Organized Health Care Education/Training Program | 1001 Main Street University At Buffalo, Department of P, 5th Floor, Buffalo, NY 14203 | 2020-06-02 |
1720601404 | Ronak Dhiraj Bahuva | Student in an Organized Health Care Education/Training Program | 955 Main Street, University At Buffalo, Jacobs School O, Buffalo, NY 14203 | 2020-05-28 |
1780207266 | Jaya Mishra | Student in an Organized Health Care Education/Training Program | 818 Ellicot Street, Buffalo, NY 14203 | 2020-05-19 |
1013530617 | Amanpreet Kaur Singh | Student in an Organized Health Care Education/Training Program | 77 Goodell Street Department of Medicine, Suite 240, Buffalo, NY 14203 | 2020-05-19 |
1013538917 | Leen Hosam Alyacoub | Student in an Organized Health Care Education/Training Program | 100 High Street, D2-76 Buffalo, Ny 14203, Buffalo Gener, Buffall, NY 14203 | 2020-05-01 |
1003436601 | Maxiam Dean | Student in an Organized Health Care Education/Training Program | Ub Family Residency Program, 77 Goodell Street, 2nd Floor, Buffalo, NY 14203 | 2020-04-23 |
1144849837 | Jennifer Anthone-kloss | Student in an Organized Health Care Education/Training Program | Anesthesiology Residency & Fellowship Programs, Ub Gateway, 77 Goodell Street, Suite 550, Buffalo, NY 14203 | 2020-04-13 |
1821658873 | Peter William Ip Fung Chun | Student in an Organized Health Care Education/Training Program | 1001 Main Street, Room 5145, Division of Pediatric Medical Education, Buffalo, NY 14203 | 2019-06-20 |
Find all providers in zip 14203 |
Taxonomy Code | 363AS0400X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Surgical Technologist |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1316460413 | Katherine Susanne Miller | Physician Assistant | 2121 Main St Ste 316, Buffalo, NY 14214-2673 | 2017-07-20 |
1306023866 | Nicole C Scovazzo | Physician Assistant | 30 N Union Rd Ste 104, Buffalo, NY 14221-5367 | 2008-01-28 |
1730294851 | Patrick Losito | Physician Assistant | 515 Abbott Rd., Suite 101, Buffalo, NY 14220 | 2006-08-20 |
1033167127 | Jennifer Lynn Noble | Physician Assistant | 875 Ellicott Street, Gates Vascular Institute, Buffalo, NY 14203 | 2006-05-04 |
1386626117 | Andrew M Dybalski | Physician Assistant | 700 Michigan Ave, Buffalo, NY 14203-1514 | 2005-11-17 |
1548828031 | Chloe Anna Carver | Physician Assistant | 462 Grider St, Buffalo, NY 14215-3098 | 2019-05-30 |
1770084329 | Rachel Michele Watt | Physician Assistant | 2157 Main St, Buffalo, NY 14214-2648 | 2018-02-27 |
1194255505 | Kurtis Matthew Downey | Physician Assistant | 565 Abbott Rd, Buffalo, NY 14220-2039 | 2017-06-18 |
1124420369 | Kathryn Wirth | Physician Assistant | 701 Seneca St Ste 646c, Buffalo, NY 14210-1351 | 2014-09-18 |
1932513991 | Neal Siejka | Physician Assistant | 700 Michigan Ave, Suite 210, Buffalo, NY 14203-1536 | 2014-06-18 |
Find all providers in BUFFALO |
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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.