Provider Demographics
NPI:1225232366
Name:MASSACHUSETTS GENERAL HOSPITAL
Entity Type:Organization
Organization Name:MASSACHUSETTS GENERAL HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ONCOLOGY NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JUDIANNE
Authorized Official - Middle Name:URMAZA
Authorized Official - Last Name:HENDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, BC
Authorized Official - Phone:617-643-2013
Mailing Address - Street 1:122 RIVERWAY
Mailing Address - Street 2:APT. 2
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-4117
Mailing Address - Country:US
Mailing Address - Phone:617-731-9745
Mailing Address - Fax:
Practice Address - Street 1:55 FRUIT ST
Practice Address - Street 2:YAWKEY BUILDING SUITE 7B
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2621
Practice Address - Country:US
Practice Address - Phone:617-643-2013
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital