Healthcare Provider Details

I. General information

NPI: 1013067057
Provider Name (Legal Business Name): LEONARDO V RIELLA M.D., PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/11/2007
Last Update Date: 08/18/2025
Certification Date: 08/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 FRUIT STREET WHITE 5
BOSTON MA
02114-2621
US

IV. Provider business mailing address

219 OLD FARM RD
NEWTON MA
02459-3437
US

V. Phone/Fax

Practice location:
  • Phone: 617-726-5050
  • Fax:
Mailing address:
  • Phone: 617-710-4600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number230644
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number230644
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: