Provider Demographics
NPI:1932175379
Name:KORZELIUS, CYNTHIA ANNE (MD)
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:ANNE
Last Name:KORZELIUS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2014 WASHINGTON ST # 2N
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02462-1607
Mailing Address - Country:US
Mailing Address - Phone:617-243-6433
Mailing Address - Fax:617-243-5148
Practice Address - Street 1:2014 WASHINGTON ST
Practice Address - Street 2:NEWTON WELLESLEY HOSPITAL, HOSPITALIST SUITE, 2 NORTH
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02462-1607
Practice Address - Country:US
Practice Address - Phone:617-243-6433
Practice Address - Fax:617-243-5148
Is Sole Proprietor?:No
Enumeration Date:2006-02-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA156597207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Not Answered207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAAA15334OtherHARVARD PILGRIM
MA3191214Medicaid
MA3571773OtherAETNA
MA9414827OtherSIGNA
MAJ19912OtherBLUE CROSS MEDEX
MA403159OtherTUFTS HEALTH PLAN
MA3127888OtherHEALTHSOURCE
MA3571773OtherAETNA
MAG89512Medicare UPIN