| Organization Name: | BETH ISRAEL DEACONESS MEDICAL CENTER |
| NPI Number: | 1003060955 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | STEPHEN DEVEAU (CONTROLLER & DIRECTOR, FISCAL SERVI) |
| Mailing Address: | 330 Brookline Ave Boston |
| State: | MA US |
| Postal Code: | 022155400 |
| Phone Number: | 6176774042 |
| Fax Number: | |
| NPI Enumeration Date: | 11/05/2008 |
| NPI Last Update Date: | 11/05/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 281PC2000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MA |
| Taxonomy Type: | Hospitals |
| Taxonomy Classification: | Chronic Disease Hospital |
| Taxonomy Specialization: | Children |
| Taxonomy Definition: | |