Provider Demographics
NPI:1588829444
Name:BOSTON MEDICAL CENTER, BOSTON
Entity Type:Organization
Organization Name:BOSTON MEDICAL CENTER, BOSTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FELLOW
Authorized Official - Prefix:
Authorized Official - First Name:NEERAJ
Authorized Official - Middle Name:
Authorized Official - Last Name:RASTOGI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:617-414-5135
Mailing Address - Street 1:40 BRATTLE ST
Mailing Address - Street 2:UNIT #1
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02476-4348
Mailing Address - Country:US
Mailing Address - Phone:781-316-2721
Mailing Address - Fax:
Practice Address - Street 1:820 HARRISON AVENUE, FGH BUILDING
Practice Address - Street 2:DEPARTMENT OF RADIOLOGY
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118
Practice Address - Country:US
Practice Address - Phone:617-414-5135
Practice Address - Fax:617-414-7924
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-21
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA226193282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital