Provider Demographics
NPI:1063054294
Name:FREIRE, BRALEY (CPT)
Entity type:Individual
Prefix:
First Name:BRALEY
Middle Name:
Last Name:FREIRE
Suffix:
Gender:F
Credentials:CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:270 HUTTLESTON AVE
Mailing Address - Street 2:
Mailing Address - City:FAIRHAVEN
Mailing Address - State:MA
Mailing Address - Zip Code:02719-1605
Mailing Address - Country:US
Mailing Address - Phone:508-997-9100
Mailing Address - Fax:508-993-5854
Practice Address - Street 1:270 HUTTLESTON AVE
Practice Address - Street 2:
Practice Address - City:FAIRHAVEN
Practice Address - State:MA
Practice Address - Zip Code:02719-1605
Practice Address - Country:US
Practice Address - Phone:508-997-9100
Practice Address - Fax:508-993-5854
Is Sole Proprietor?:No
Enumeration Date:2019-10-09
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist