Provider Demographics
NPI:1043536865
Name:TERAN, BRETT JOSEPH (DO)
Entity type:Individual
Prefix:
First Name:BRETT
Middle Name:JOSEPH
Last Name:TERAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 RESNIK RD
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-4842
Mailing Address - Country:US
Mailing Address - Phone:781-934-2400
Mailing Address - Fax:508-746-3930
Practice Address - Street 1:41 RESNIK RD
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-4842
Practice Address - Country:US
Practice Address - Phone:781-934-2400
Practice Address - Fax:508-746-3930
Is Sole Proprietor?:No
Enumeration Date:2010-04-19
Last Update Date:2020-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI61907-21208100000X
MA262968208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation