Provider Demographics
NPI:1790059988
Name:EHE INTERNATIONAL BOSTON
Entity Type:Organization
Organization Name:EHE INTERNATIONAL BOSTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARIANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:DYKE
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE PRACTITIONER
Authorized Official - Phone:617-526-8888
Mailing Address - Street 1:125 HIGH ST
Mailing Address - Street 2:OLIVER TOWER, 18TH FLOOR
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02110-2704
Mailing Address - Country:US
Mailing Address - Phone:617-526-8888
Mailing Address - Fax:617-526-0188
Practice Address - Street 1:125 HIGH ST
Practice Address - Street 2:OLIVER TOWER, 18TH FLOOR
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02110-2704
Practice Address - Country:US
Practice Address - Phone:617-526-8888
Practice Address - Fax:617-526-0188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-06
Last Update Date:2012-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1800XAmbulatory Health Care FacilitiesClinic/CenterCorporate Health