NPIMap

Brewer Nystuen Pediatrics

Organization Active NPI Pediatrics Physician · Melrose, MA

NPI 1104034065 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1104034065
Entity type
Organization (NPI type 2)
Primary specialty
Pediatrics Physician 208000000X
Legal business name
BREWER NYSTUEN PEDIATRICS
Practice address
548 Lebanon St
Melrose, MA 02176-3226
Phone
(781) 665-4364
NPI assigned
May 21, 2007
Organization subpart
No

Authorized official

Name
Miss Karen Anne Yarasits, OFFICE MANAGER
Title
Office Manager
Phone
(781) 665-4364

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
22D0705514Brewer Nystuen Pediatrics
548 Lebanon Street, Melrose, MA 02176		Certificate of waiverAug 31, 2026

National Provider Directory

Tax ID family
Brewer Nystuen Pediatric Associates (2 organizations share this tax ID)

Locations

548 Lebanon St
Melrose, MA 02176
Phone (781) 665-4364

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician
Group: 193400000X SINGLE SPECIALTY GROUP		 208000000X Yes

Addresses

Primary practice location

548 Lebanon St
Melrose, MA 02176-3226

Mailing address

548 Lebanon St
Melrose, MA 02176-3226
Phone (781) 665-4364

Other providers in Melrose, MA

All providers in Melrose, MA · Pediatrics Physician in Massachusetts

Sources for this page

Verify at the official NPI Registry.