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General NPI Number Information
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NPI Number | 1497151773
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Entity Type | Organization
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Legal Business Name | ASSOCIATED PHYSICIANS OF HARVARD MEDICAL FACULTY PHYSICIANS AT BETH IS
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Dates
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Enumeration Date | 11/13/2014
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Last Update Date | 12/31/2018
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Provider Practice Location Address
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Address Line | 330 BROOKLINE AVE HOSPITALIST PROGRAM, PBS 2
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City | BOSTON
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State | MA
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Zip | 02215-5400
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Country | US
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Telephone | 617-754-4667
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Fax | 617-632-0215
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Provider Business Mailing Address
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Address Line | 375 LONGWOOD AVE # MASCO3
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City | BOSTON
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State | MA
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Zip | 02215-5395
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Country | US
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Telephone | 617-632-7441
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Fax | 617-632-7570
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | ALEXANDRA BOER KIMBALL
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Credential | MD
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Telephone | 781-632-7444
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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