| Caritas St.elizabeth's Medical Center-psychiatry | |
|
736 Cambridge St Boston MA 02135-2907 | |
| (617) 789-5173 | |
| Not Available |
| Full Name | Caritas St.elizabeth's Medical Center-psychiatry |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 736 Cambridge St, Boston, Massachusetts |
| Authorized Official Name and Position | Miles Converdale (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 6175625460 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Caritas St.elizabeth's Medical Center-psychiatry 77 Warren Street-provider Enrollment Dept Brighton MA 02135 Ph: (617) 562-5482 | Caritas St.elizabeth's Medical Center-psychiatry 736 Cambridge St Boston MA 02135-2907 Ph: (617) 789-5173 |
| NPI Number | 1316001761 |
|---|---|
| Provider Enumeration Date | 12/20/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316001761 | NPI | - | NPPES |
| 1001884 | Medicaid | MA | |
| 1201719 | Medicaid | MA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | (* (Not Available)) | Primary |
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