Provider Demographics
NPI:1104355353
Name:KONIARES, KATHERINE (MD)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:KONIARES
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 1:300 BOYLSTON ST STE 300
Mailing Address - Street 2:
Mailing Address - City:CHESTNUT HILL
Mailing Address - State:MA
Mailing Address - Zip Code:02467-1976
Mailing Address - Country:US
Mailing Address - Phone:617-449-9750
Mailing Address - Fax:617-449-9751
Practice Address - Street 1:300 BOYLSTON ST STE 300
Practice Address - Street 2:
Practice Address - City:CHESTNUT HILL
Practice Address - State:MA
Practice Address - Zip Code:02467-1976
Practice Address - Country:US
Practice Address - Phone:617-449-9750
Practice Address - Fax:617-449-9751
Is Sole Proprietor?:No
Enumeration Date:2017-06-09
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA271203207V00000X
MA1020058207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology