Healthcare Provider Details

I. General information

NPI: 1306131933
Provider Name (Legal Business Name): BRENDAN J CONNELL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2011
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41 MALL ROAD LAHEY HOSPITAL AND MEDICAL CENTER
BOSTON MA
01805-0001
US

IV. Provider business mailing address

55 FRUIT ST
BOSTON MA
02114-2696
US

V. Phone/Fax

Practice location:
  • Phone: 781-744-8400
  • Fax: 781-744-5245
Mailing address:
  • Phone: 617-726-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number257299
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: