Organization
BRIGHAM AND WOMENS PHYSICIANS ORGANIZATION INC
Active
Organization
BRIGHAM AND WOMENS PHYSICIANS ORGANIZATION INC
Active
Other names
dba Dept of Neurology
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM C JOHNSTON (CFO)
(617) 713-2263
Entity
Organization
Contact information
Practice address
75 FRANCIS ST, BOSTON, MA 02115-6110
(617) 732-5500
Mailing address
111 CYPRESS ST, BROOKLINE, MA 02445-6002
(617) 582-1200
(617) 713-2283
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
—
—
2084N0400X
Neurology Physician
Primary
—
—
2084N0600X
Clinical Neurophysiology Physician
—
—
2084P0005X
Neurodevelopmental Disabilities Physician
—
—
2084P2900X
Pain Medicine (Psychiatry & Neurology) Physician
—
—
2084V0102X
Vascular Neurology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9709339
—
MA
01
—
M17826
BCBS NEUROLOGY GRP #
MA
Enumeration date
07/17/2006
Last updated
04/08/2011
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