Provider Demographics
NPI:1033890694
Name:BLUE HILL PSYCHIATRY PLLC
Entity Type:Organization
Organization Name:BLUE HILL PSYCHIATRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:AMAL
Authorized Official - Middle Name:
Authorized Official - Last Name:KIMAWI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:617-678-2430
Mailing Address - Street 1:399 BOYLSTON ST FL 6
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02116-3325
Mailing Address - Country:US
Mailing Address - Phone:617-420-5850
Mailing Address - Fax:617-399-9750
Practice Address - Street 1:399 BOYLSTON ST FL 6
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02116-3325
Practice Address - Country:US
Practice Address - Phone:617-420-5850
Practice Address - Fax:617-399-9750
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-27
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No2084P0015XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychosomatic MedicineGroup - Multi-Specialty