MEDICARE: YULIANA BRIKMAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	217299	MA

General Provider Information

NPI Number	:	1194763755
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YULIANA BRIKMAN

Provider Business Mailing Address
First Line	:	398 NEPONSET AVE
Second Line	:
City	:	DORCHESTER
State	:	MA
Zip	:	02122-3134
Country	:	US
Telephone Number	:	617-282-3200
Fax Number	:

Provider Business Practice Location Address
First Line	:	2210 DORCHESTER AVE
Second Line	:
City	:	DORCHESTER CENTER
State	:	MA
Zip	:	02124-5607
Country	:	US
Telephone Number	:	617-282-3200
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/03/2006
Last Update Date	:	06/11/2012

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