Dr. Ivy L Brackup, MD
Family Medicine in Dorchester, Massachusetts
1184691891- Practice location
- 1353 Dorchester Ave, Dorchester, MA 02122-2932
- Phone
- 617-288-3230
- Fax
- —
- Last updated
- September 11, 2024
Ivy Lynn Brackup is a Family Medicine based in Dorchester, MA. Ivy Lynn Brackup practices in Dorchester, MA and has the professional credentials of MD. The NPI Number for Ivy Lynn Brackup is 1184691891 and holds a License No. 15530 (MA). The current practice location address for Ivy Lynn Brackup is 1353 Dorchester Ave, Dorchester, MA 02122-2932 and can be reached out via phone at 617-288-3230.
Provider Profile Details
- NPI Number
- 1184691891
- Provider Name
- Ivy Lynn Brackup
- Credential
- MD
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 1353 Dorchester Ave, Dorchester, MA 02122-2932
- Phone Number
- 617-288-3230
- Primary Taxonomy
- Family Medicine · 207Q00000X
- Sole Proprietor
- No
- Provider Enumeration Date
- March 1, 2006
- Last Update Date
- September 11, 2024
- Certification Date
- September 11, 2024
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 1353 Dorchester Ave
Dorchester, MA 02122-2932 - City
- Dorchester
- State
- Massachusetts
- Zip
- 02122-2932
- Phone Number
- 617-288-3230
Provider Business Mailing Address Details
- Address
- 1353 Dorchester Ave
Dorchester, MA 02122-2932 - City
- Dorchester
- State
- MA
- Zip
- 02122-2932
- Phone Number
- 617-288-3230
License Information
- License Number
- 15530
- License State
- MA
- Taxonomy
- Family Medicine · 207Q00000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
Other Family Medicine providers near Dorchester, MA
View all Family Medicine providers in Dorchester →Frequently Asked Questions
What is the NPI number of Dr. Ivy L Brackup, MD?
The NPI number of Dr. Ivy L Brackup, MD is 1184691891. It was assigned on March 1, 2006 and is currently active in the NPPES registry.
What is the specialty of Dr. Ivy L Brackup, MD?
Dr. Ivy L Brackup, MD is registered under the primary taxonomy Family Medicine (code 207Q00000X), licensed in MA under license number 15530.
Where does Dr. Ivy L Brackup, MD practice?
The practice location is 1353 Dorchester Ave, Dorchester, MA 02122-2932. The office can be reached at 617-288-3230 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1184691891 directly on the NPPES registry website.