| Center For Brain Health Pllc | |
|
1101 Beacon St Ste 1w Brookline MA 02446-5587 | |
| (617) 855-7288 | |
| (844) 733-6150 |
| Full Name | Center For Brain Health Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1101 Beacon St Ste 1w, Brookline, Massachusetts |
| Authorized Official Name and Position | Omar S Haque (OWNER/AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 6178557288 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Center For Brain Health Pllc 1101 Beacon St Ste 1w Brookline MA 02446-5587 Ph: (617) 855-7288 | Center For Brain Health Pllc 1101 Beacon St Ste 1w Brookline MA 02446-5587 Ph: (617) 855-7288 |
| NPI Number | 1144731225 |
|---|---|
| Provider Enumeration Date | 10/17/2017 |
| Last Update Date | 10/17/2017 |
| Medicare PECOS PAC ID | 8527334911 |
|---|---|
| Medicare Enrollment ID | O20171031001142 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144731225 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Omar Sultan Haque |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1528406196 PECOS PAC ID: 9739483694 Enrollment ID: I20170928000042 |
| Provider Name | Sherley Valcourt Boisvert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902306897 PECOS PAC ID: 9739591843 Enrollment ID: I20210126002079 |
| Provider Name | Holly Ann Kalinay |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740962463 PECOS PAC ID: 7315397965 Enrollment ID: I20231222002313 |
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