Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 16721 | MA |
N | 207QA0401X | Family Doctor - Addiction Medicine | 207994 | MA |
N | 208D00000X | General Practice Physician | 207994 | MA |
NPI | 1922045038 |
---|---|
Provider Name | Dr. Vasumathi Keith Brown |
First Address | Holliston, MA 01746-1549 |
Second Address | Lowell, MA 01852-2228 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2006 |
Last Update Date | 07/05/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2025710 | (05) | MA |
AA38478 | HARVARD PILGRIM HEALTH CA (01) | |
H38643 | (02) | MA |
J28547 | BLUE CROSS BLUE SHIELD (01) | |
P00716212 | RAILROAD MEDICARE (01) | MA |