Provider Demographics
NPI:1932167939
Name:BROWN, CHRISTOPHER R (OD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:R
Last Name:BROWN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 BOSTON RD
Mailing Address - Street 2:
Mailing Address - City:BILLERICA
Mailing Address - State:MA
Mailing Address - Zip Code:01821-5316
Mailing Address - Country:US
Mailing Address - Phone:978-667-0481
Mailing Address - Fax:978-670-7778
Practice Address - Street 1:700 BOSTON RD
Practice Address - Street 2:
Practice Address - City:BILLERICA
Practice Address - State:MA
Practice Address - Zip Code:01821-5316
Practice Address - Country:US
Practice Address - Phone:978-667-0481
Practice Address - Fax:978-670-7778
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2018-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4520152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0704059Medicaid
MAW1761402Medicare PIN
MAW1761401Medicare PIN