# BETH ISRAEL DEACONESS MEDICAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568493971
- **Authorized official:** MS. JULIE MANGANIELLO (BIDPO- ENROLLMENT &CREDENTIALING)
- **Authorized official phone:** (671) 754-8782

## Contact information

- **Practice address:** 330 BROOKLINE AVE, REN 8, BOSTON, MA 02215-5400
- **Practice address phone:** (617) 667-4623
- **Mailing address:** 330 BROOKLINE AVE, REN 8, BOSTON, MA 02215-5400
- **Mailing address phone:** (617) 667-4623

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 282N00000X | General Acute Care Hospital | 106994 | MA | Yes |

## Other

- **Enumeration date:** 07/05/2006
- **Last updated:** 08/22/2020