Organization
BRIGHAM AND WOMENS PHYSICIANS ORGANIZATION INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM C JOHNSTON (CFO)
(617) 713-2263
Entity
Organization
Contact information
Practice address
75 FRANCIS ST, DEPARTMENT OF RADIOLOGY, BRIGHAM & WOMEN'S HOSPITAL, BOSTON, MA 02115-6110
(617) 732-6273
(617) 278-6940
Mailing address
111 CYPRESS ST, BROOKLINE, MA 02445-6002
(617) 582-1200
(617) 713-2283
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
—
—
2085N0700X
Neuroradiology Physician
—
—
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
2085R0204X
Vascular & Interventional Radiology Physician
—
—
2085R0205X
Radiological Physics Physician
—
—
2085U0001X
Diagnostic Ultrasound Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
687908
TUFTS
MA
05
—
9700811
—
MA
01
—
CH5598
MEDICARE RAILROAD
—
01
—
M17353
BLUE CROSS/BLUE SHIELD
MA
Enumeration date
07/07/2006
Last updated
04/07/2011
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