Healthcare Provider Details

I. General information

NPI: 1730772815
Provider Name (Legal Business Name): CHRISTOPHER JACOB MAGNANI MD, MS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/18/2021
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

165 CAMBRIDGE ST
BOSTON MA
02114-2783
US

IV. Provider business mailing address

165 CAMBRIDGE ST
BOSTON MA
02114-2783
US

V. Phone/Fax

Practice location:
  • Phone: 617-726-2000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number1027010
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: