Basic Information
Provider Information
NPI: 1255737995
EntityType: 2
ReplacementNPI:  
OrganizationName: BRIGHAM AND WOMEN'S
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 25 CHURCH ST
Address2: APT 1
City: BOSTON
State: MA
PostalCode: 021165547
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 75 FRANCIS ST
Address2: NEVILLE HOUSE
City: BOSTON
State: MA
PostalCode: 021156110
CountryCode: US
TelephoneNumber: 6177325636
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/07/2014
LastUpdateDate: 11/20/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: AARONSON
AuthorizedOfficialFirstName: EMILY
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: RESIDENT
AuthorizedOfficialTelephone: 3124153610
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: MD
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
282N00000X248731MAY HospitalsGeneral Acute Care Hospital 

No ID Information.


Home