Provider Demographics
NPI:1659379022
Name:BROWNRIDGE, DANIEL C (MSPT)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:C
Last Name:BROWNRIDGE
Suffix:
Gender:M
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 LIBERTY SQ
Mailing Address - Street 2:BSMT 1
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02109-5814
Mailing Address - Country:US
Mailing Address - Phone:617-536-1161
Mailing Address - Fax:857-239-9711
Practice Address - Street 1:654 BEACON ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-2099
Practice Address - Country:US
Practice Address - Phone:617-536-1161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-11
Last Update Date:2020-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA15747225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAAA 27096OtherHARVARD PILGRIM PROV #
MAY67972OtherBC/BS PROV #
MABR Y68777Medicare ID - Type UnspecifiedPHYSICAL THERAPY PROV #