Organization
HARVARD MEDICAL FACULTY PHYS AT BETH ISRAEL DEACONESS MED CTR INC
Active
Other names
HMFP - Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALEXANDRA BOER KIMBALL MD (CHIEF EXECUTIVE OFFICER)
(781) 632-7441
Entity
Organization
Contact information
Practice address
330 BROOKLINE AVE, BOSTON, MA 02215-5400
(617) 632-7441
Mailing address
375 LONGWOOD AVE STE 3, BOSTON, MA 02215-5395
(617) 632-7441
(617) 632-7570
Taxonomy
Speciality
Code
Description
License number
State
204F00000X
Transplant Surgery Physician
—
—
207T00000X
Neurological Surgery Physician
—
—
207W00000X
Ophthalmology Physician
—
—
207Y00000X
Otolaryngology Physician
—
—
208200000X
Plastic Surgery Physician
—
—
208600000X
Surgery Physician
Primary
—
—
2086S0129X
Vascular Surgery Physician
—
—
2086X0206X
Surgical Oncology Physician
—
—
208800000X
Urology Physician
—
—
208C00000X
Colon & Rectal Surgery Physician
—
—
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
—
—
213E00000X
Podiatrist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9761314
—
MA
Enumeration date
05/09/2006
Last updated
09/21/2023
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