Organization
BOSTON PEDIATRIC NEUROSURGICAL FOUNDATION, INC.
Active
Other names
Department of Neurosurgery, Children's Hospital Boston
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN M HICKEY (PROVIDER ENROLLMENT MANAGER)
(617) 355-4956
Entity
Organization
Contact information
Practice address
300 LONGWOOD AVE, DEPARTMENT OF NEUROSURGERY, CHILDREN'S HOSPITAL BOSTON, BOSTON, MA 02115-5724
(617) 355-6446
(617) 730-0906
Mailing address
300 LONGWOOD AVE., HUNNEWELL 2, DEPARTMENT OF NEUROSURGERY, CHILDREN'S HOSPITAL BOSTON, BOSTON, MA 02115-5724
(617) 355-6446
(617) 730-0906
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
—
—
363LP0200X
Pediatric Nurse Practitioner
—
—
Other
Enumeration date
07/04/2006
Last updated
05/08/2023
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