Provider Demographics
NPI:1427459296
Name:BOSTON CHILDREN'S HOSPITAL
Entity type:Organization
Organization Name:BOSTON CHILDREN'S HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR OF VAD/CAMP
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:VANDERPLUYM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:617-355-6329
Mailing Address - Street 1:300 LONGWOOD AVE
Mailing Address - Street 2:6 SOUTH
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-5724
Mailing Address - Country:US
Mailing Address - Phone:857-218-4974
Mailing Address - Fax:617-730-4636
Practice Address - Street 1:300 LONGWOOD AVE
Practice Address - Street 2:6 SOUTH
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-5724
Practice Address - Country:US
Practice Address - Phone:857-218-4974
Practice Address - Fax:617-730-4636
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-11
Last Update Date:2014-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA56280282NC2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC2000XHospitalsGeneral Acute Care HospitalChildren