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General NPI Number Information
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NPI Number | 1891752200
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Entity Type | Individual
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Provider Name | MICHAEL J HEALEY MD
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Gender | Male
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Dates
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Enumeration Date | 04/28/2006
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Last Update Date | 04/10/2012
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Provider Practice Location Address
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Address Line | 1153 CENTRE ST BRIGHAM PRIMARY PHYSICIANS AT FAULKNER HOSPITAL
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City | JAMAICA PLAIN
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State | MA
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Zip | 02130-3450
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Country | US
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Telephone | 617-983-4430
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Fax |
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Provider Business Mailing Address
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Address Line | 111 CYPRESS ST BRIGHAM AND WOMEN'S PHYSICIANS ORGANIZATION
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City | BROOKLINE
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State | MA
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Zip | 02445-6002
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Country | US
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Telephone | 617-983-4430
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 212315
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License Number State | MA
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