Basic Information
| Provider Information | |||||||||
| NPI: | 1336723204 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CASTRO-RIVERA | ||||||||
| FirstName: | CRISTINA | ||||||||
| MiddleName: | MICHELLE | ||||||||
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| Credential: | MDPHD | ||||||||
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| Mailing Information | |||||||||
| Address1: | INTERNAL MEDICINE RESIDENCY TRAINING PROGRAM | ||||||||
| Address2: | 330 BROOKLINE AVE | ||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 02215 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6176677000 | ||||||||
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| Practice Location | |||||||||
| Address1: | BETH ISRAEL DEACONESS MEDICAL CENTER | ||||||||
| Address2: | INTERNAL MEDICINE RESIDENCY TRAINING PROGRAM- DEAC 307C | ||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 02215 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6176328310 | ||||||||
| FaxNumber: | 6176328261 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/07/2021 | ||||||||
| LastUpdateDate: | 07/27/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/30/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207R00000X | T289577 | MA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.