Provider Demographics
NPI:1356456321
Name:BROWN, KRISTEN (OD)
Entity Type:Individual
Prefix:DR
First Name:KRISTEN
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:KRISTEN
Other - Middle Name:
Other - Last Name:FILLION
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:930 COMMONWEALTH AVE
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-1274
Mailing Address - Country:US
Mailing Address - Phone:617-262-2020
Mailing Address - Fax:
Practice Address - Street 1:400 COMMONWEALTH AVE STE 2
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-2849
Practice Address - Country:US
Practice Address - Phone:617-426-0370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3930152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA06786OtherDAVIS VISION PROVIDER #
MAW16260OtherBCBSMA ID #
MAAA111772OtherHARVARD PILGRIM
MA2575678OtherAETNA PROVIDER NUMBER
MAW1734501OtherMEDICARE
MA0010778OtherNHP SERVICE PROVIDER #
MA22-02738OtherUNITED HEALTH CARE PROVID
MA1301144Medicaid
MA003930OtherTUFTS PROVIDER NUMBER