Provider Demographics
NPI:1972885416
Name:BRIEN, MICHAEL P (RPH)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:P
Last Name:BRIEN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 FRIEND ST
Mailing Address - Street 2:
Mailing Address - City:GLOUCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01930-2946
Mailing Address - Country:US
Mailing Address - Phone:978-283-5434
Mailing Address - Fax:
Practice Address - Street 1:106 FRIEND ST
Practice Address - Street 2:
Practice Address - City:GLOUCESTER
Practice Address - State:MA
Practice Address - Zip Code:01930-2946
Practice Address - Country:US
Practice Address - Phone:978-283-5434
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-11
Last Update Date:2011-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA17036183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist