Provider Demographics
NPI:1932337888
Name:KWAIT, DYLAN COOL (MD)
Entity Type:Individual
Prefix:
First Name:DYLAN
Middle Name:COOL
Last Name:KWAIT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1 CHRYSLER RD
Mailing Address - Street 2:APT. 1108
Mailing Address - City:NATICK
Mailing Address - State:MA
Mailing Address - Zip Code:01760-1650
Mailing Address - Country:US
Mailing Address - Phone:781-710-9570
Mailing Address - Fax:
Practice Address - Street 1:75 FRANCIS ST
Practice Address - Street 2:DEPARTMENT OF RADIOLOGY
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-6110
Practice Address - Country:US
Practice Address - Phone:781-710-9570
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-30
Last Update Date:2014-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY602535422085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology