Provider Demographics
NPI:1588677090
Name:BRINK, STUART J (MD)
Entity Type:Individual
Prefix:DR
First Name:STUART
Middle Name:J
Last Name:BRINK
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Gender:M
Credentials:MD
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Mailing Address - Street 1:40 2ND AVE
Mailing Address - Street 2:NEW ENGLAND DIABETES & ENDOCRINOLOGY CENTER, SUITE #170
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02451-1132
Mailing Address - Country:US
Mailing Address - Phone:781-890-3610
Mailing Address - Fax:781-890-3612
Practice Address - Street 1:40 2ND AVE
Practice Address - Street 2:NEW ENGLAND DIABETES & ENDOCRINOLOGY CENTER, SUITE #170
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02451-1132
Practice Address - Country:US
Practice Address - Phone:781-890-3610
Practice Address - Fax:781-890-3612
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2013-04-10
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Provider Licenses
StateLicense IDTaxonomies
MA390442080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2046725Medicaid
MA2046725Medicaid
MAD88177Medicare UPIN