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General NPI Number Information
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NPI Number | 1316111511
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Entity Type | Organization
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Legal Business Name | CARITAS ST ELIZABETH MEDICAL CENTER
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Dates
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Enumeration Date | 04/17/2008
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Last Update Date | 04/17/2008
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Provider Practice Location Address
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Address Line | 12 CELESTINE TER
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City | STONEHAM
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State | MA
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Zip | 02180-3320
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Country | US
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Telephone | 781-438-1641
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Fax |
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Provider Business Mailing Address
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Address Line | 736 CAMBRIDGE ST
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City | BRIGHTON
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State | MA
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Zip | 02135-2907
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Country | US
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Telephone | 617-789-3000
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Fax |
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Authorized Official
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Title or Position | PROGRAM DIRECTOR
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Name | JOHN UNTERBORN
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Credential | MD
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Telephone | 617-789-3000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 225497
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License Number State | MA
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