Healthcare Provider Details

I. General information

NPI: 1225479033
Provider Name (Legal Business Name): BRIGHAM AND WOMEN'S HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2013
Last Update Date: 07/09/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 FRANCIS ST
BOSTON MA
02115-6110
US

IV. Provider business mailing address

75 FRANCIS STREET
BOSTON MA
02116
US

V. Phone/Fax

Practice location:
  • Phone: 617-732-5500
  • Fax:
Mailing address:
  • Phone: 617-732-5500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number256364
License Number StateMA

VIII. Authorized Official

Name: MS. NINA GILL
Title or Position: RESIDENT
Credential: M.D.
Phone: 617-525-7278