Provider Demographics
NPI:1386869212
Name:BRIAN J. AWBREY
Entity type:Organization
Organization Name:BRIAN J. AWBREY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:AWBREY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:617-726-3808
Mailing Address - Street 1:151 MERRIMAC ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114-4714
Mailing Address - Country:US
Mailing Address - Phone:617-726-3808
Mailing Address - Fax:617-726-4812
Practice Address - Street 1:151 MERRIMAC ST
Practice Address - Street 2:SUITE 202
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-4714
Practice Address - Country:US
Practice Address - Phone:617-726-3808
Practice Address - Fax:617-726-4812
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA54010207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAAA38232OtherHPHC
NH30213869Medicaid
MA99187102OtherNEWORK HEALTH
MAM17486OtherBCBS OF MA