Provider Demographics
NPI:1407852775
Name:BROWNE, KEVIN L (PT)
Entity type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:L
Last Name:BROWNE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:485 ARSENAL ST
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02472-5091
Mailing Address - Country:US
Mailing Address - Phone:617-972-5255
Mailing Address - Fax:617-972-5271
Practice Address - Street 1:485 ARSENAL ST
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:MA
Practice Address - Zip Code:02472-5091
Practice Address - Country:US
Practice Address - Phone:617-972-5255
Practice Address - Fax:617-972-5271
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2009-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA187922251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME022184OtherANTHEM BC/BS
MEAA3837OtherHARVARDPILGRIMHEALTHCARE
ME7829776OtherCIGNA
ME431547500Medicaid
ME431547500Medicaid