Basic Information
| Provider Information | |||||||||
| NPI: | 1336421445 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BRIGHAM AND WOMEN'S HOSPITAL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1243 BEACON ST | ||||||||
| Address2: | 2A | ||||||||
| City: | BROOKLINE | ||||||||
| State: | MA | ||||||||
| PostalCode: | 024465274 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8577569299 | ||||||||
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| Practice Location | |||||||||
| Address1: | 75 FRANCIS ST | ||||||||
| Address2: | |||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021156110 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6177328210 | ||||||||
| FaxNumber: | 6177309534 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/14/2011 | ||||||||
| LastUpdateDate: | 09/14/2011 | ||||||||
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| AuthorizedOfficialLastName: | HOLCK | ||||||||
| AuthorizedOfficialFirstName: | GUILHERME | ||||||||
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| AuthorizedOfficialTitleorPosition: | OBSTETRIC ANESTHESIA FELLOW | ||||||||
| AuthorizedOfficialTelephone: | 6177325500 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | PARTNERS HEALTHCARE SYSTEM | ||||||||
| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282NW0100X | 248265 | MA | Y | Hospitals | General Acute Care Hospital | Women |
No ID Information.