Healthcare Provider Details

I. General information

NPI: 1841120177
Provider Name (Legal Business Name): ROIE TZADOK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BETH ISRAEL DEACONESS MEDICAL CENTER, DIVISION OF GASTR 330 BROOKLINE AVE.
BOSTON MA
02215
US

IV. Provider business mailing address

BETH ISRAEL DEACONESS MEDICAL CENTER, DIVISION OF GASTR 330 BROOKLINE AVE.
BOSTON MA
02215
US

V. Phone/Fax

Practice location:
  • Phone: 617-667-8427
  • Fax:
Mailing address:
  • Phone: 617-667-8427
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number3019767
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: