Healthcare Provider Details

I. General information

NPI: 1851745525
Provider Name (Legal Business Name): BRIAN LIKE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/19/2016
Last Update Date: 04/18/2023
Certification Date: 11/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 BROOKLINE AVE. YAMINS 210
BOSTON MA
02215
US

IV. Provider business mailing address

330 BROOKLINE AVE. YAMINS 210
BOSTON MA
02215
US

V. Phone/Fax

Practice location:
  • Phone: 617-278-8000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number286666
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: