Provider Demographics
NPI:1215395678
Name:ALLINGTON, KELLY JEAN
Entity Type:Individual
Prefix:MRS
First Name:KELLY
Middle Name:JEAN
Last Name:ALLINGTON
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:KELLY
Other - Middle Name:JEAN
Other - Last Name:WEIDEMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:310 PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:ELMIRA
Mailing Address - State:NY
Mailing Address - Zip Code:14904-1458
Mailing Address - Country:US
Mailing Address - Phone:607-733-2820
Mailing Address - Fax:607-733-0402
Practice Address - Street 1:310 PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:ELMIRA
Practice Address - State:NY
Practice Address - Zip Code:14904-1458
Practice Address - Country:US
Practice Address - Phone:607-733-2820
Practice Address - Fax:607-733-0402
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-01
Last Update Date:2016-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator