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Contact Information

KELLEY A PRENDERGAST, PA
175 CONNORS STREET
GARDNER, MA01440
 Phone: 978-410-6121
 Fax: 978-410-6109
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for KELLEY A PRENDERGAST · (Female)

NPI Number 1033189352
Status Active
Credentials PA (Physician Assistant)
Entity Individual
Enumeration date 01/26/2006
Last updated 10/28/2015 - About 11 years ago
Sole proprietor 1 No
Identifiers
  • MA License # AP2003
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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