Provider Demographics
NPI:1497411193
Name:BARBOSA BROWN, EMA ALICE (RD)
Entity Type:Individual
Prefix:MRS
First Name:EMA
Middle Name:ALICE
Last Name:BARBOSA BROWN
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 ROCKLAND ST
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MA
Mailing Address - Zip Code:02021-3192
Mailing Address - Country:US
Mailing Address - Phone:573-489-1729
Mailing Address - Fax:
Practice Address - Street 1:BWH AND BWH-FAULKNER HOSPITAL
Practice Address - Street 2:75 FRANCIS ST, ASBII 3RD FLOOR & 5TH FL. FH SUITE D
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115
Practice Address - Country:US
Practice Address - Phone:617-732-8884
Practice Address - Fax:617-264-6315
Is Sole Proprietor?:No
Enumeration Date:2021-11-17
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2354133VN1201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1201XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Obesity and Weight Management