Provider Demographics
NPI:1437959004
Name:TAMS, CHRISTIAN BRODE (MS RD LDN)
Entity type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:BRODE
Last Name:TAMS
Suffix:
Gender:M
Credentials:MS RD LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74 LONGFELLOW RD
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02462-1508
Mailing Address - Country:US
Mailing Address - Phone:413-313-8766
Mailing Address - Fax:
Practice Address - Street 1:74 LONGFELLOW RD
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02462-1508
Practice Address - Country:US
Practice Address - Phone:413-313-8766
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-13
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA860776922255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer