Provider Demographics
NPI:1013269703
Name:BURREN, CHRISTOPHER BRIAN (NBC-HIS)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:BRIAN
Last Name:BURREN
Suffix:
Gender:M
Credentials:NBC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1130 TEN ROD RD OFC PARK
Mailing Address - Street 2:BUILDING E, SUITE 304
Mailing Address - City:NORTH KINGSTOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02852-4161
Mailing Address - Country:US
Mailing Address - Phone:401-667-5880
Mailing Address - Fax:
Practice Address - Street 1:200 MIDWAY RD
Practice Address - Street 2:SUITE 161
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02920-5748
Practice Address - Country:US
Practice Address - Phone:401-944-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-05
Last Update Date:2012-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI2364237700000X
MA2364237700000X
NH2364237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI2363OtherHEALTH INSURANCE FOR HEARING AID BENEFIT