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General NPI Number Information
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NPI Number | 1891356374
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Entity Type | Organization
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Legal Business Name | MASS GENERAL BRIGHAM COMMUNITY PHYSICIANS INC.
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Dates
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Enumeration Date | 06/25/2019
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Last Update Date | 12/22/2025
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Provider Practice Location Address
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Address Line | 50 TREMONT ST STE 101
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City | MELROSE
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State | MA
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Zip | 02176-2721
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Country | US
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Telephone | 781-979-3440
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Fax |
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Provider Business Mailing Address
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Address Line | 399 REVOLUTION DR STE 1010
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City | SOMERVILLE
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State | MA
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Zip | 02145-1582
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT & COO
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Name | LYNN STOFER
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Credential |
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Telephone | 857-282-5157
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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