1417252255 NPI number — CHILDREN'S HOSPITAL BOSTON

Table of content: (NPI 1417252255)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417252255 NPI number — CHILDREN'S HOSPITAL BOSTON

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHILDREN'S HOSPITAL BOSTON
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1417252255
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/25/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
RASHI ST. 2/2
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HAIFA
Provider Business Mailing Address State Name:
ISRAEL
Provider Business Mailing Address Postal Code:
33271
Provider Business Mailing Address Country Code:
IL
Provider Business Mailing Address Telephone Number:
00972502063177
Provider Business Mailing Address Fax Number:
0097248542231

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
RASHI ST. 2/2
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HAIFA
Provider Business Practice Location Address State Name:
ISRAEL
Provider Business Practice Location Address Postal Code:
33271
Provider Business Practice Location Address Country Code:
IL
Provider Business Practice Location Address Telephone Number:
00972502063177
Provider Business Practice Location Address Fax Number:
0097248542231
Provider Enumeration Date:
01/25/2011

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BUCHMILLER
Authorized Official First Name:
TERRY
Authorized Official Middle Name:
L
Authorized Official Title or Position:
CO DIRECTOR ADVANCED FETAL CENTRE
Authorized Official Telephone Number:
617-355-8445

Provider Taxonomy Codes

  • Taxonomy code: 281PC2000X , with the licence number:  87826 ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)