Lally, Patricia E

Lally, Patricia E is an individual health care provider with primary practice located at 645 Kanawha Ave , Rainelle WV 25962-1013. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Lally, Patricia E can be contacted via phone (304) 438-6188.

Contact Information

Primary practice address
645 Kanawha Ave Rainelle WV 25962-1013
Phone: (304) 438-6188
Fax: (304) 438-4037
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 1529 West Virginia

Profile Details

NPI number 1871564245
LBN Legal business name Lally, Patricia E
Credentials DO MPH
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 1st, 2006
Last updated Aug 27th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1871564245 NPPES
West Virginia Other 5336168 AETNA
West Virginia MEDICAID 0110398000 AETNA
West Virginia Other 1719217 AETNA
West Virginia Other P00067677 AETNA
West Virginia Other P99827 AETNA

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