Provider Demographics
NPI:1790913853
Name:KINYOTA, STELLA (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:STELLA
Middle Name:
Last Name:KINYOTA
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:316 WAVERLEY ST
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:MA
Mailing Address - Zip Code:02478-2422
Mailing Address - Country:US
Mailing Address - Phone:617-855-5230
Mailing Address - Fax:240-348-9555
Practice Address - Street 1:316 WAVERLEY ST
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:MA
Practice Address - Zip Code:02478-2422
Practice Address - Country:US
Practice Address - Phone:617-855-5230
Practice Address - Fax:240-348-9555
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-29
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA253567207Q00000X
GA003791207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine