Healthcare Provider Details

I. General information

NPI: 1356456321
Provider Name (Legal Business Name): KRISTEN BROWN O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KRISTEN FILLION O.D.

II. Dates (important events)

Enumeration Date: 08/20/2006
Last Update Date: 12/12/2024
Certification Date: 12/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 BEDFORD STREET SUITE 102
BOSTON MA
02111
US

IV. Provider business mailing address

930 COMMONWEALTH AVE SUITE 2A
BOSTON MA
02215-1274
US

V. Phone/Fax

Practice location:
  • Phone: 617-426-0370
  • Fax:
Mailing address:
  • Phone: 617-262-2020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number3930
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: