Provider Demographics
NPI:1679547830
Name:GUARNIERI, KENNETH FRANK (MD)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:FRANK
Last Name:GUARNIERI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:72 CUDWORTH RD
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01570-3157
Mailing Address - Country:US
Mailing Address - Phone:508-461-0011
Mailing Address - Fax:508-461-0010
Practice Address - Street 1:72 CUDWORTH RD
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:MA
Practice Address - Zip Code:01570-3157
Practice Address - Country:US
Practice Address - Phone:508-461-0011
Practice Address - Fax:508-461-0010
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2010-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA70743207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAE76196Medicare UPIN