Provider Demographics
NPI:1558847269
Name:QUADROS, KENNETH (MBBS FRCPC (CAN))
Entity Type:Individual
Prefix:
First Name:KENNETH
Middle Name:
Last Name:QUADROS
Suffix:
Gender:M
Credentials:MBBS FRCPC (CAN)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1575 TREMONT ST APT 807
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02120-1632
Mailing Address - Country:US
Mailing Address - Phone:857-222-0483
Mailing Address - Fax:
Practice Address - Street 1:BIRGHAM AND WOMENS HOSPITAL, DIVISION OF CARDIOLOGY
Practice Address - Street 2:45 FRANCIS ST
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115
Practice Address - Country:US
Practice Address - Phone:857-222-0483
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-16
Last Update Date:2018-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program