Provider Demographics
NPI:1710193412
Name:BETH R HARDIMAN, M.D.
Entity Type:Organization
Organization Name:BETH R HARDIMAN, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:HAUSNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-497-9500
Mailing Address - Street 1:300 MOUNT AUBURN ST
Mailing Address - Street 2:SUITE 313
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02138-5600
Mailing Address - Country:US
Mailing Address - Phone:617-497-9500
Mailing Address - Fax:617-497-1511
Practice Address - Street 1:300 MOUNT AUBURN ST
Practice Address - Street 2:SUITE 313
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138-5600
Practice Address - Country:US
Practice Address - Phone:617-497-9500
Practice Address - Fax:617-497-1511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA72909174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty