MEDICARE: KAREN GAIL BRANDSE MD & ASSOC

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	207R00000X	Internal Medicine Physician	153726	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	66912	OTHER	MA	HPHC
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	M18407	OTHER	MA	BCBS
4	691581	OTHER	MA	TUFTS

General Provider Information

NPI Number	:	1588645782
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KAREN GAIL BRANDSE MD & ASSOC

Provider Business Mailing Address
First Line	:	460 TOTTEN POND RD
Second Line	:	C O MZI
City	:	WALTHAM
State	:	MA
Zip	:	02451-1906
Country	:	US
Telephone Number	:	781-890-9933
Fax Number	:	781-890-9950

Provider Business Practice Location Address
First Line	:	67 UNION ST
Second Line	:
City	:	NATICK
State	:	MA
Zip	:	01760-7700
Country	:	US
Telephone Number	:	508-650-7640
Fax Number	:	508-650-7814

Authorized Official
Title or Position	:	PRESIDENT
Name	:	KAREN GAIL BRANDSE
Credential	:	MD
Telephone Number	:	508-650-7640

Provider Enumeration Date	:	11/07/2005
Last Update Date	:	08/22/2020

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