Healthcare Provider Details

I. General information

NPI: 1184730160
Provider Name (Legal Business Name): RENEE BRANT M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 LINCOLN ST
NEWTON HIGHLANDS MA
02461-1527
US

IV. Provider business mailing address

33 MAPLE AVE
NEWTON MA
02458-1923
US

V. Phone/Fax

Practice location:
  • Phone: 617-964-6982
  • Fax: 617-969-7803
Mailing address:
  • Phone: 617-965-5935
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number35703
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number35703
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: