# THE SHRINERS' HOSPITAL FOR CHILDREN

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- **Entity:** Organization
- **Status:** Active
- **Other names:** The Shriners' Hospital for Children Professional Services
- **Organization subpart:** No

## Provider details

- **NPI number:** 1366886525
- **Authorized official:** JERRY G. GANTT (CHAIRMAN OF THE BOARD OF TRUSTEES)
- **Authorized official phone:** (132) 810-3008

## Contact information

- **Practice address:** 51 BLOSSOM ST, BOSTON, MA 02114-2601
- **Practice address phone:** (617) 371-2300
- **Practice address fax:** (617) 371-4818
- **Mailing address:** PO BOX 8500, LOCKBOX 7642, PHILADELPHIA, PA 19178-7642
- **Mailing address phone:** (617) 371-2300
- **Mailing address fax:** (617) 371-4818

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |
| 208200000X | Plastic Surgery Physician | — | NULL | — |
| 208200000X | Plastic Surgery Physician | — | — | — |
| 208600000X | Surgery Physician | — | NULL | — |
| 208600000X | Surgery Physician | — | — | — |
| 2086S0120X | Pediatric Surgery Physician | — | NULL | Yes |
| 2086S0120X | Pediatric Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/18/2013
- **Last updated:** 04/16/2019