Individual
MARK E BRACKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
41 MALL RD., LAHEY CLINIC, BURLINGTON, MA 01805-0001
(781) 744-8100
(781) 744-5213
Mailing address
41 MALL RD., LAHEY CLINIC, BURLINGTON, MA 01805-0001
(781) 744-8100
(781) 744-5213
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
160536
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0130711
—
MA
05
—
110002578A
—
MA
Enumeration date
02/15/2006
Last updated
09/09/2011
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