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Organization
MASSACHUSETTS GENERAL HOSPITAL
Active
Organization
MASSACHUSETTS GENERAL HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACLYN MCGOWAN C.P.N.P. (PEDIATRIC NURSE PRACTITIONER)
(857) 998-1840
Entity
Organization
Contact information
Practice address
55 FRUIT ST, ELLISON 18 PEDIATRICS, BOSTON, MA 02114-2621
(617) 643-0722
Mailing address
55 FRUIT ST, ELLISON 18 PEDIATRICS, BOSTON, MA 02114-2621
Taxonomy
Speciality
Code
Description
License number
State
282NC2000X
Children's Hospital
Primary
RN283317
MA
Other
Enumeration date
10/08/2012
Last updated
10/08/2012
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