Individual
TRISTA A BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
119 BELMONT ST, DEPT OF ORTHOPEDICS, WORCESTER, MA 01605-2903
(508) 334-8689
(508) 334-9769
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
(800) 225-8885
(508) 334-1977
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
036110768
IL
208100000X
Physical Medicine & Rehabilitation Physician
Primary
246354
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01621490
BCBS PROVIDER ID
IL
05
—
036-110768
—
IL
05
—
036110768
—
IL
05
—
110087984A
—
MA
01
—
131667300
OWCP PROVIDER ID
IL
01
—
P00146855
RAILROAD MEDICARE
IL
Enumeration date
09/21/2005
Last updated
10/27/2020
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