Provider Demographics
NPI:1164459020
Name:KINLAY, SCOTT (MBBS PHD)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:
Last Name:KINLAY
Suffix:
Gender:M
Credentials:MBBS PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 VFW PKWY
Mailing Address - Street 2:CARDIOLOGY DIVISION
Mailing Address - City:WEST ROXBURY
Mailing Address - State:MA
Mailing Address - Zip Code:02132-4927
Mailing Address - Country:US
Mailing Address - Phone:857-203-6840
Mailing Address - Fax:857-203-5550
Practice Address - Street 1:1400 VFW PKWY
Practice Address - Street 2:CARDIOLOGY DIVISION
Practice Address - City:WEST ROXBURY
Practice Address - State:MA
Practice Address - Zip Code:02132-4927
Practice Address - Country:US
Practice Address - Phone:857-203-6840
Practice Address - Fax:857-203-5550
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2015-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA205430207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease