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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