Organization
HARVARD MEDICAL FACULTY PHYS AT BETH ISRAEL DEACONESS MED CTR, INC
Active
Other names
Ophthalmogic/Surgery - HMFP@BIDMC
Organization subpart
No
Provider details
NPI number
Authorized official
ALEXANDRA BOER KIMBALL MD (CHIEF EXECUTIVE OFFICER)
(617) 632-7444
Entity
Organization
Contact information
Practice address
330 BROOKLINE AVE, MASCO 3, BOSTON, MA 02215
(617) 667-5088
Mailing address
375 LONGWOOD AVE STE 3, BOSTON, MA 02215-5395
(617) 632-7444
(617) 632-7570
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9753419
—
MA
Enumeration date
07/14/2006
Last updated
05/29/2018
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