Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0401X | Family Doctor - Addiction Medicine | PA435 | MA |
NPI | 1578062758 |
---|---|
Provider Name | Robynne Brown |
First Address | Newton, MA 02459-1003 |
Second Address | Quincy, MA 02169-4510 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2018 |
Last Update Date | 02/02/2018 |