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General NPI Number Information
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NPI Number | 1699160432
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Entity Type | Organization
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Legal Business Name | BETH ISRAEL DEACONESS MEDICAL CENTER, INC.
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Dates
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Enumeration Date | 03/30/2015
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Last Update Date | 03/30/2015
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Provider Practice Location Address
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Address Line | 908 PINE ST. APT 2F
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City | PHILADELPHIA
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State | PA
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Zip | 19107
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Country | US
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Telephone | 703-507-4289
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Fax |
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Provider Business Mailing Address
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Address Line | 908 PINE ST APT 2F
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City | PHILADELPHIA
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State | PA
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Zip | 19107-6190
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Country | US
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Telephone | 703-507-4289
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Fax |
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Authorized Official
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Title or Position | RESIDENT
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Name | ALEXANDER CHALPHIN
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Credential | M.D.
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Telephone | 703-507-4289
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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 |
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License Number State |
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