Provider Demographics
NPI:1649571597
Name:BRIAR, CHARLOTTE (BM BCH)
Entity Type:Individual
Prefix:
First Name:CHARLOTTE
Middle Name:
Last Name:BRIAR
Suffix:
Gender:F
Credentials:BM BCH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CHILDREN'S HOSPITAL
Mailing Address - Street 2:300 LONGWOOD AVE.
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115
Mailing Address - Country:US
Mailing Address - Phone:617-355-6000
Mailing Address - Fax:
Practice Address - Street 1:CHILDREN'S HOSPITAL
Practice Address - Street 2:300 LONGWOOD AVE.
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115
Practice Address - Country:US
Practice Address - Phone:617-355-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-09
Last Update Date:2010-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAL-239648208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics