Bronwen C Carroll, MD | |
840 Harrison Ave, Menino 1, Boston, MA 02118-2905 | |
(617) 414-4991 | |
(617) 414-4999 |
Full Name | Bronwen C Carroll |
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Gender | Female |
Speciality | Pediatrics - Pediatric Emergency Medicine |
Location | 840 Harrison Ave, Boston, Massachusetts |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1366578197 | NPI | - | NPPES |
110082537A | Medicaid | MA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 237078 (Massachusetts) | Secondary |
2080P0204X | Pediatrics - Pediatric Emergency Medicine | 237078 (Massachusetts) | Primary |
Entity Name | Child Health Foundation Of Boston Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1619969920 PECOS PAC ID: 1557263340 Enrollment ID: O20040122000712 |
Mailing Address | Practice Location Address |
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Bronwen C Carroll, MD Bmc Provider Enrollment Office, 960 Massachusetts Ave,.2nd Floor, Boston, MA 02118 Ph: () - | Bronwen C Carroll, MD 840 Harrison Ave, Menino 1, Boston, MA 02118-2905 Ph: (617) 414-4991 |
Puja Banka, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 300 Longwood Ave, Bader 203, Boston, MA 02115 Phone: 617-355-6363 | |
Angela M. Jacques, MD Pediatrics Medicare: Medicare Enrolled Practice Location: Massachusetts General Hospital, 55 Fruit St., Boston, MA 02114 Phone: 617-726-2066 | |
Dr. Elizabeth S Taglauer, M.D., PH.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 300 Longwood Ave, Boston, MA 02115 Phone: 617-355-6000 | |
Cailyn Hereen Rood, MD Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 300 Longwood Ave, Boston, MA 02115 Phone: 617-355-6000 | |
Dr. Alon Peltz, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 300 Longwood Ave, Boston, MA 02115 Phone: 617-355-6000 | |
Miki Nishitani, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 300 Longwood Ave, Boston, MA 02115 Phone: 617-355-6000 | |
Vickren Pillay, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 300 Longwood Ave, Boston, MA 02115 Phone: 617-355-6000 |