Provider Demographics
NPI:1053795138
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:DIRECTOR, FAMILY SERVICES DEPT
Authorized Official - Prefix:
Authorized Official - First Name:PEDRO
Authorized Official - Middle Name:
Authorized Official - Last Name:GARRIDO-CASTILLO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:617-983-6013
Mailing Address - Street 1:20 RADCLIFFE RD
Mailing Address - Street 2:APT 411
Mailing Address - City:ALLSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02134-2552
Mailing Address - Country:US
Mailing Address - Phone:331-643-0058
Mailing Address - Fax:
Practice Address - Street 1:3297 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:JAMAICA PLAIN
Practice Address - State:MA
Practice Address - Zip Code:02130-2655
Practice Address - Country:US
Practice Address - Phone:617-522-4700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-17
Last Update Date:2015-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health