Provider Demographics
NPI:1649333840
Name:BRIGHAM AND WOMEN'S HOSPITAL
Entity type:Organization
Organization Name:BRIGHAM AND WOMEN'S HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD, PHD
Authorized Official - Prefix:
Authorized Official - First Name:SIBINKA
Authorized Official - Middle Name:
Authorized Official - Last Name:BAJIC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-459-7172
Mailing Address - Street 1:49 WORTHINGTON ST APT 39
Mailing Address - Street 2:
Mailing Address - City:ROXBURY CROSSING
Mailing Address - State:MA
Mailing Address - Zip Code:02120-1647
Mailing Address - Country:US
Mailing Address - Phone:617-459-7172
Mailing Address - Fax:
Practice Address - Street 1:75 FRANCIS ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-6110
Practice Address - Country:US
Practice Address - Phone:617-732-8213
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA224839282N00000X, 282NW0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered282N00000XHospitalsGeneral Acute Care Hospital
Not Answered282NW0100XHospitalsGeneral Acute Care HospitalWomen