Provider Demographics
NPI:1538706098
Name:GOVONI, KALEY
Entity type:Individual
Prefix:
First Name:KALEY
Middle Name:
Last Name:GOVONI
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 CHESTER RD
Mailing Address - Street 2:
Mailing Address - City:BLANDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01008-9521
Mailing Address - Country:US
Mailing Address - Phone:413-977-2081
Mailing Address - Fax:
Practice Address - Street 1:84 HIGHLAND AVE STE 311
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-2733
Practice Address - Country:US
Practice Address - Phone:978-998-0010
Practice Address - Fax:978-224-2990
Is Sole Proprietor?:No
Enumeration Date:2019-12-04
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program