Basic Information
| Provider Information | |||||||||
| NPI: | 1851427553 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NEW ENGLAND BAPTIST HOSPITAL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5 HARTFORD CT | ||||||||
| Address2: | |||||||||
| City: | DORCHESTER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021252823 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6174455757 | ||||||||
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| Practice Location | |||||||||
| Address1: | 125 PARKER HILL AVE | ||||||||
| Address2: | |||||||||
| City: | ROXBURY CROSSING | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021202847 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6177545800 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/26/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | CHANEL | ||||||||
| AuthorizedOfficialFirstName: | YVEDA | ||||||||
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| AuthorizedOfficialTitleorPosition: | STAFF THERAPIST | ||||||||
| AuthorizedOfficialTelephone: | 6177545800 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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| AuthorizedOfficialCredential: | OTR | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | AH1966 | MA | Y | Hospitals | General Acute Care Hospital |
No ID Information.