Healthcare Provider Details

I. General information

NPI: 1144545690
Provider Name (Legal Business Name): ELENA BETH BROWN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2010
Last Update Date: 07/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 CAMBRIDGE ST
BURLINGTON MA
01803-3766
US

IV. Provider business mailing address

621 HAVERHILL ST
READING MA
01867-1153
US

V. Phone/Fax

Practice location:
  • Phone: 781-272-4667
  • Fax:
Mailing address:
  • Phone: 781-272-4667
  • Fax: 781-270-4196

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number259239
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: