Organization
HARVARD MEDICAL FACULTY PHYS AT BETH ISRAEL DEACONESS MED CTR INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEXANDRA BOER KIMBALL MD (CHIEF EXECUTIVE OFFICER)
(617) 632-7441
Entity
Organization
Contact information
Practice address
330 BROOKLINE AVE, BOSTON, MA 02215
(617) 754-2339
Mailing address
375 LONGWOOD AVE STE 3, BOSTON, MA 02215-5395
(617) 632-7441
Taxonomy
Speciality
Code
Description
License number
State
282NC0060X
Critical Access Hospital
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9753419
—
MA
Enumeration date
09/20/2006
Last updated
06/15/2018
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