Provider Demographics
NPI:1790812105
Name:MASSACHUSETTS GENERAL HOSPITAL
Entity Type:Organization
Organization Name:MASSACHUSETTS GENERAL HOSPITAL
Other - Org Name:PARTNERS HEALTH CARE
Other - Org Type:Other Name
Authorized Official - Title/Position:CLINICAL PRACTICE ASSISTANT
Authorized Official - Prefix:MS
Authorized Official - First Name:SHANEE
Authorized Official - Middle Name:ADORN
Authorized Official - Last Name:HAYNES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-726-3907
Mailing Address - Street 1:32 WILMINGTON ST
Mailing Address - Street 2:
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02301-1628
Mailing Address - Country:US
Mailing Address - Phone:508-587-2556
Mailing Address - Fax:508-587-2556
Practice Address - Street 1:32 WILMINGTON ST
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-1628
Practice Address - Country:US
Practice Address - Phone:508-587-2556
Practice Address - Fax:508-587-2556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital