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General NPI Number Information
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NPI Number | 1770574527
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Entity Type | Organization
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Legal Business Name | CARITAS ST. ELIZABETH'S MEDICAL CENTER
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Dates
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Enumeration Date | 11/01/2005
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Last Update Date | 09/04/2009
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Provider Practice Location Address
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Address Line | 77 WARREN ST ST. ELIZABETHS HEALTHCARE
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City | BRIGHTON
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State | MA
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Zip | 02135
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Country | US
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Telephone | 617-562-5460
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Fax | 617-562-5480
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Provider Business Mailing Address
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Address Line | CARITAS ST ELIZABETHS MEDICAL CTR P.O. BOX 3777
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City | BOSTON
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State | MA
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Zip | 02241-0001
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Country | US
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Telephone | 617-562-5460
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Fax | 617-562-5480
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. DAVID CHICOINE
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Credential |
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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