Individual
CHARLES MATS BERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NURSE PRACTITIONER
Contact information
Practice address
51 BLOSSOM ST, BOSTON, MA 02114-2601
(617) 722-3000
Mailing address
46 GARDNER ST APT 2, CHELSEA, MA 02150-2129
(781) 475-3312
Taxonomy
Speciality
Code
Description
License number
State
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
RN2264496
MA
363LP0200X
Pediatric Nurse Practitioner
Primary
RN2264496
MA
Other
Enumeration date
03/21/2018
Last updated
09/20/2022
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