Kelly Ann Bevilaqua-Tracy, PA

NPI #1114179637 in Scranton, Pennsylvania

Provider Information

NPI Number: 1114179637
Entity Type: Individual
Name: Kelly Ann Bevilaqua-Tracy, PA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA
Enumeration Date: Oct 15, 2008
Last Updated: Dec 30, 2020

Practice Location

Address: 1800 MULBERRY ST
City: Scranton
State: Pennsylvania
ZIP Code: 18510-2369
Phone: (570) 703-4830

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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