Provider Demographics
NPI:1306811013
Name:REMBETSY-BROWN, LISA (MD)
Entity type:Individual
Prefix:DR
First Name:LISA
Middle Name:
Last Name:REMBETSY-BROWN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 WYMAN RD
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01473-1601
Mailing Address - Country:US
Mailing Address - Phone:978-874-6409
Mailing Address - Fax:978-874-5590
Practice Address - Street 1:16 WYMAN RD
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01473-1601
Practice Address - Country:US
Practice Address - Phone:978-874-6409
Practice Address - Fax:978-874-5590
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2010-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA73806207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MASX1081Medicare PIN