| Harvard Medical Faculty Phys At Beth Israel Deaconess Med Ctr Inc | |
|
330 Brookline Ave Boston MA 02215-5400 | |
| (617) 632-7441 | |
| (617) 667-2767 |
| Full Name | Harvard Medical Faculty Phys At Beth Israel Deaconess Med Ctr Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 330 Brookline Ave, Boston, Massachusetts |
| Authorized Official Name and Position | Stuart Rosenberg (PRESIDENT) |
| Authorized Official Contact | 6176327441 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Harvard Medical Faculty Phys At Beth Israel Deaconess Med Ctr Inc 400 Blue Hill Drive Suite 2b Westwood MA 02090-2161 Ph: (617) 754-1000 | Harvard Medical Faculty Phys At Beth Israel Deaconess Med Ctr Inc 330 Brookline Ave Boston MA 02215-5400 Ph: (617) 632-7441 |
| NPI Number | 1225078801 |
|---|---|
| Provider Enumeration Date | 06/08/2006 |
| Last Update Date | 12/10/2024 |
| Medicare PECOS PAC ID | 4486567104 |
|---|---|
| Medicare Enrollment ID | O20031204000414 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225078801 | NPI | - | NPPES |
| 9753389 | Medicaid | MA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| Provider Name | Douglas M Horst |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518957224 PECOS PAC ID: 5890730006 Enrollment ID: I20050628000017 |
| Provider Name | Zhenghui Jiang |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1053605477 PECOS PAC ID: 6103195490 Enrollment ID: I20170629001674 |
| Provider Name | Dimitrios Farmakiotis |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1255625919 PECOS PAC ID: 9931328028 Enrollment ID: I20250117002964 |
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