Evangeline Brennan-Koliscz

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

Practice address

1563 N Main St
Suite 208
Fall River, MA 02720-2983

Phone

(508) 324-1060

Fax

(508) 679-8590

NPI assigned

Jul 28, 2008

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• South Bay Early Intervention

  • Early Intervention Provider Agency
  • Fall River, MA
  • NPI 1841451705
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1217203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217203200000",
    "number": "1265697361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CENTRE ST",
            "city": "RUMFORD",
            "state": "RI",
            "postal_code": "029163144",
            "telephone_number": "401-435-8008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1563 N MAIN ST",
            "address_2": "SUITE 208",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027202983",
            "telephone_number": "508-324-1060",
            "fax_number": "508-679-8590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRENNAN-KOLISCZ",
        "first_name": "EVANGELINE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-28",
        "last_updated": "2008-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Braga, NP
• Brandon A Bray
• Brayton SNF Opco LLC
• Susan E Braz-Martin, MD
• Jessica Breen Sheth, PA-C
• Kathryn Brennan, MS
• Aaron Brett
• Katelyn Bridgestock, RD, LDN, CLC
• Kathleen P Briggs, NP
• Lane R Briggs

• Early Intervention Provider Agency in Fall River, MA
• Providers in Fall River, MA by specialty
• Early Intervention Provider Agency in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.