Doctor Name: | SUSAN S. BRILL |
NPI Number: | 1619055316 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APRN,BC |
License Number: | 134544 |
Business Practice Address: | 454 Walnut St Newtonville, MA - 024602280 |
Business Phone Number: | 6178694458 |
Business Fax Number: | |
Mailing Address: | 454 Walnut St, NEWTONVILLE |
State: | MA |
Postal Code: | 024602280 |
Phone Number: | 6178694458 |
Fax Number: | |
NPI Enumeration Date: | 11/01/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WP0808X |
License Number: | 134544 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | Psych/Mental Health |
Taxonomy Definition: |