Provider Demographics
NPI:1720343759
Name:BROMLEY, ADRIAN
Entity Type:Individual
Prefix:MS
First Name:ADRIAN
Middle Name:
Last Name:BROMLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 WACHUSETT ST
Mailing Address - Street 2:APT. 1
Mailing Address - City:JAMAICA PLAIN
Mailing Address - State:MA
Mailing Address - Zip Code:02130-4139
Mailing Address - Country:US
Mailing Address - Phone:401-440-6088
Mailing Address - Fax:
Practice Address - Street 1:63 WACHUSETT ST
Practice Address - Street 2:APT. 1
Practice Address - City:JAMAICA PLAIN
Practice Address - State:MA
Practice Address - Zip Code:02130-4139
Practice Address - Country:US
Practice Address - Phone:401-440-6088
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-05
Last Update Date:2012-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist