Basic Information
| Provider Information | |||||||||
| NPI: | 1649333840 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BRIGHAM AND WOMEN'S HOSPITAL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 49 WORTHINGTON ST APT 39 | ||||||||
| Address2: | |||||||||
| City: | ROXBURY CROSSING | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021201647 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6174597172 | ||||||||
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| Practice Location | |||||||||
| Address1: | 75 FRANCIS ST | ||||||||
| Address2: | |||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021156110 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6177328213 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/18/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | BAJIC | ||||||||
| AuthorizedOfficialFirstName: | SIBINKA | ||||||||
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| AuthorizedOfficialTitleorPosition: | MD, PHD | ||||||||
| AuthorizedOfficialTelephone: | 6174597172 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | 224839 | MA | X | Hospitals | General Acute Care Hospital | 282NW0100X | 224839 | MA | X | Hospitals | General Acute Care Hospital | Women |
No ID Information.