Basic Information
| Provider Information | |||||||||
| NPI: | 1073570016 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AMRIEN | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | JAY | ||||||||
| NamePrefix: | PROF. | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 151 EVERETT AVE | ||||||||
| Address2: | |||||||||
| City: | CHELSEA | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021501812 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6178848300 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 151 EVERETT AVE | ||||||||
| Address2: | |||||||||
| City: | CHELSEA | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021501812 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6178848300 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/26/2006 | ||||||||
| LastUpdateDate: | 08/14/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/14/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | PA00787 | RI | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 363A00000X | PA4175 | MA | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.