Individual provider · Type 1 NPI

Phyllis J. Kornguth, MD, PhD

Diagnostic Radiology Physician · Boston, MA

NPI number 1790741155 Active

Practice location

133 Brookline Ave
Boston, MA 02215-3904

Call (617) 421-1000 Map

Fax (617) 421-6084

Mailing address

147 Milk St, Provider Enrollment Department - 9th Floor
Boston, MA 02109-4806

Specialties and licenses

TaxonomyCodeLicense
Diagnostic Radiology Physician Primary 2085R0202X41281 (MA)

Diagnostic Radiology Physician: A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

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About NPI 1790741155

Phyllis J. Kornguth, MD, PhD's National Provider Identifier is 1790741155, issued on Apr 25, 2006. The primary taxonomy on file is Diagnostic Radiology Physician (2085R0202X), and the practice location is in Boston, MA. The record was last updated on Jan 4, 2012.