| 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 | Jaeyoung Han | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1881296556 PECOS PAC ID: 3375950629 Enrollment ID: I20210401002141  | 
| Provider Name | Holly Ann Kalinay | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1740962463 PECOS PAC ID: 7315397965 Enrollment ID: I20231222002313  | 
| Provider Name | Maxwell Joseph Schoenfeld | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1720845852 PECOS PAC ID: 1456883305 Enrollment ID: I20241016001997  | 
| Provider Name | Nicole Kennedy | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1184496457 PECOS PAC ID: 3274068010 Enrollment ID: I20241203001240  | 
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