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BRIGHAM AND WOMENS PHYSICIANS ORGANIZATION INC NPI 1083647648


NPI Information

NPI: 1083647648
Provider Name: BRIGHAM AND WOMENS PHYSICIANS ORGANIZATION INC

Doing Business As: DBA DEPT OF DERMATOLOGY

Classification: Dermatology - 207N00000X
Entity Type: Organization

CLIA Number: 22D0954962

Address:
221 LONGWOOD AVE
BOSTON, MA
ZIP 02115
Phone: (617) 732-4918
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BRIGHAM AND WOMENS PHYSICIANS ORGANIZATION INC is a dermatology in Boston, MA. The provider is a dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. BRIGHAM AND WOMENS PHYSICIANS ORGANIZATION INC NPI is 1083647648. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Dba Dept Of Dermatology.

The provider's business location address is:

221 LONGWOOD AVE
BOSTON, MA
ZIP 02115-804
Phone: (617) 732-4918

The provider's authorized official is William C Johnston .
The authorized official title is Cfo and has the following contact phone number (617) 713-2263.

The CLIA number assigned to this NPI record is 22D0954962 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 7/8/2006 and was last updated on 4/7/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207ND0101XDermatologyMOHS-Micrographic SurgeryNo
2207ND0900XDermatologyDermatopathologyNo
3207NI0002XDermatologyClinical & Laboratory Dermatological ImmunologyNo
4207NS0135XDermatologyProcedural DermatologyNo
5207N00000XDermatologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1M20857MEDICARE ID-TYPE UNSPECIFIEDMASSACHUSETTSMCARE DERM GRP #
29702610MEDICAIDMASSACHUSETTS
3M17625OTHERMASSACHUSETTSBCBS DERM GRP #

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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