Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 56429 | MA |
NPI | 1104825959 |
---|---|
Provider Name | Bryann Bromley |
First Address | Worcester, MA 01608-1604 |
Second Address | Brookline, MA 02445-7224 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2005 |
Last Update Date | 31/07/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3020304 | (05) | MA |
B74814 | (02) |