# HARVARD MEDICAL FACULTY PHYS AT BETH ISRAEL DEACONESS MED CTR INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Vascular/Surgery - HMFP at BIDMC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1891736310
- **Authorized official:** DR. ALEXANDRA BOER KIMBALL MD (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (617) 632-7444

## Contact information

- **Practice address:** 330 BROOKLINE AVE, BOSTON, MA 02215
- **Practice address phone:** (617) 632-7390
- **Mailing address:** 375 LONGWOOD AVE STE 3B, BOSTON, MA 02215-5395
- **Mailing address phone:** (781) 528-2835
- **Mailing address fax:** (617) 754-1050

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0129X | Vascular Surgery Physician | — | NULL | Yes |
| 2086S0129X | Vascular Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/08/2006
- **Last updated:** 09/20/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 9760911 | — | MA |