Provider Demographics
NPI:1639323223
Name:AURORA HOSPITALIST SERVICES
Entity Type:Organization
Organization Name:AURORA HOSPITALIST SERVICES
Other - Org Name:JOHN BREDA
Other - Org Type:Other Name
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:BREDA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:781-444-2230
Mailing Address - Street 1:253 GREENDALE AVE
Mailing Address - Street 2:
Mailing Address - City:NEEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02494-2026
Mailing Address - Country:US
Mailing Address - Phone:781-444-2230
Mailing Address - Fax:
Practice Address - Street 1:253 GREENDALE AVE
Practice Address - Street 2:
Practice Address - City:NEEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02494-2026
Practice Address - Country:US
Practice Address - Phone:781-444-2230
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-09
Last Update Date:2009-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA155371207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty