Provider Demographics
NPI:1700191814
Name:CHILDRENS HOSPITAL BOSTON
Entity Type:Organization
Organization Name:CHILDRENS HOSPITAL BOSTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT PROFESSOR OF NEUROLOGY
Authorized Official - Prefix:DR
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:SOUL
Authorized Official - Suffix:
Authorized Official - Credentials:MD,CM, FRCPC
Authorized Official - Phone:617-355-8994
Mailing Address - Street 1:591 VFW PKWY
Mailing Address - Street 2:HANCOCK VILLAGE ,298 INDEPENDENCE DRIVE,CHESTNUT HILL
Mailing Address - City:CHESTNUT HILL
Mailing Address - State:MA
Mailing Address - Zip Code:02467-3620
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:300 LONGWOOD AVE
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-5724
Practice Address - Country:US
Practice Address - Phone:617-355-6000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-12
Last Update Date:2010-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC2000XHospitalsGeneral Acute Care HospitalChildren