Provider Demographics
NPI:1184865594
Name:LAI, KENNY C (MD)
Entity Type:Individual
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First Name:KENNY
Middle Name:C
Last Name:LAI
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Gender:M
Credentials:MD
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Mailing Address - Street 1:330 BROOKLINE AVE
Mailing Address - Street 2:BETH ISRAEL DEACONESS MEDICAL CENTER DEPT OF RADIOLOGY
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-5400
Mailing Address - Country:US
Mailing Address - Phone:617-667-3532
Mailing Address - Fax:617-667-3537
Practice Address - Street 1:330 BROOKLINE AVE
Practice Address - Street 2:BETH ISRAEL DEACONESS MEDICAL CENTER DEPT OF RADIOLOGY
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-5400
Practice Address - Country:US
Practice Address - Phone:617-667-3532
Practice Address - Fax:617-667-3537
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-13
Last Update Date:2022-02-11
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Provider Licenses
StateLicense IDTaxonomies
MA2390282085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology