Timothy Raymond Kelliher
Neurologist
83 Herrick St Ste 1001
Beverly
, Massachusetts 01915-2753
Timothy Raymond Kelliher
Neurologist
83 Herrick St Ste 1001
Beverly
, Massachusetts 01915-2753
(978) 922-2226
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About
Features
Specialties
- Neurologist
Languages spoken
- English
Location
First Address
- Timothy Raymond Kelliher
- 83 Herrick St Ste 1001
- Beverly, MA
- Zip : 01915-2753
- Phone : (978) 922-2226
Second Address
- Timothy Raymond Kelliher
- 83 Herrick St Ste 1001
- Beverly, MA
- Zip : 01915-2753
- Fax : (978) 922-2269
- Phone : (978) 922-2226
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2084N0400X | Neurologist | 75613 | MA |
National Provider Identifier
| NPI | 1043314198 |
|---|---|
| Provider Name | Timothy Raymond Kelliher |
| First Address | Beverly, MA 01915-2753 |
| Second Address | Beverly, MA 01915-2753 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 11/09/2006 |
| Last Update Date | 28/05/2020 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 722666 | TUFTS (01) | |
| 814325 | AETNA USHC (01) | |
| A20168 | (05) | MA |
| DM9771 | HCHP (01) | |
| G26268 | (02) | |
| J31266 | BLUE CROSS (01) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.