Mark F Bryan

Individual provider Active NPI Community/Behavioral Health Agency · Wakefield, MA

NPI 1356974091 · NPPES record last updated Feb 21, 2020

Key facts

NPI
1356974091
Entity type
Individual (NPI type 1)
Primary specialty
Community/Behavioral Health Agency 251S00000X
Practice address
37 Water St
Wakefield, MA 01880-3058
Phone
(781) 851-2648
NPI assigned
Feb 21, 2020
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Yes

Addresses

Primary practice location

37 Water St
Wakefield, MA 01880-3058

Mailing address

45 Avon St Apt 3
Wakefield, MA 01880-2585
Phone (781) 568-9001

Other providers in Wakefield, MA

All providers in Wakefield, MA · Community/Behavioral Health Agency in Massachusetts

Sources for this page

Verify at the official NPI Registry.