Provider Demographics
NPI:1699160432
Name:BETH ISRAEL DEACONESS MEDICAL CENTER, INC.
Entity type:Organization
Organization Name:BETH ISRAEL DEACONESS MEDICAL CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:CHALPHIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-507-4289
Mailing Address - Street 1:908 PINE ST APT 2F
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-6190
Mailing Address - Country:US
Mailing Address - Phone:703-507-4289
Mailing Address - Fax:
Practice Address - Street 1:908 PINE ST. APT 2F
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107
Practice Address - Country:US
Practice Address - Phone:703-507-4289
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-30
Last Update Date:2015-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital