Organization
THE SHRINERS' HOSPITAL FOR CHILDREN
Active
Other names
The Shriners' Hospital for Children Professional Services
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY G. GANTT (CHAIRMAN OF THE BOARD OF TRUSTEES)
(132) 810-3008
Entity
Organization
Contact information
Practice address
51 BLOSSOM ST, BOSTON, MA 02114-2601
(617) 371-2300
(617) 371-4818
Mailing address
PO BOX 8500, LOCKBOX 7642, PHILADELPHIA, PA 19178-7642
(617) 371-2300
(617) 371-4818
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
—
—
208200000X
Plastic Surgery Physician
—
—
208600000X
Surgery Physician
—
—
2086S0120X
Pediatric Surgery Physician
Primary
—
—
Other
Enumeration date
04/18/2013
Last updated
04/16/2019
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