Provider Demographics
NPI:1437138716
Name:KALELI, ADNAN (MD)
Entity Type:Individual
Prefix:DR
First Name:ADNAN
Middle Name:
Last Name:KALELI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1147 HANCOCK ST
Mailing Address - Street 2:SUITE 205
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-4343
Mailing Address - Country:US
Mailing Address - Phone:617-472-7003
Mailing Address - Fax:617-471-9910
Practice Address - Street 1:1147 HANCOCK ST
Practice Address - Street 2:SUITE 205
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-4343
Practice Address - Country:US
Practice Address - Phone:617-472-7003
Practice Address - Fax:617-471-9910
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-13
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA53276208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ03492OtherBLUE CROSS BLUE SHIELD #
MA053276OtherTUFTS #
MA27139OtherHARVARD PILGRIM #
MA340001241OtherRAIL ROAD MEDICARE #
MAB700142OtherCIGNA #
MA00928558OtherAETNA #
MA6180892Medicaid
MA00928558OtherAETNA #
MA6180892Medicaid