Organization
MWHLPHO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRICIA BRISBOIS (MANAGER)
(978) 764-8628
Entity
Organization
Contact information
Practice address
13 BRADLEE ROAD, MEDFORD, MA 02155
(781) 395-1110
(781) 395-8553
Mailing address
13 BRADLEE ROAD, MEDFORD, MA 02155
(781) 395-1110
(781) 395-8553
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
60673
MA
Other
Enumeration date
09/05/2018
Last updated
12/27/2021
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