Provider Demographics
NPI:1851427553
Name:NEW ENGLAND BAPTIST HOSPITAL
Entity Type:Organization
Organization Name:NEW ENGLAND BAPTIST HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:STAFF THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:YVEDA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHANEL
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:617-754-5800
Mailing Address - Street 1:5 HARTFORD CT
Mailing Address - Street 2:
Mailing Address - City:DORCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:02125-2823
Mailing Address - Country:US
Mailing Address - Phone:617-445-5757
Mailing Address - Fax:
Practice Address - Street 1:125 PARKER HILL AVE
Practice Address - Street 2:
Practice Address - City:ROXBURY CROSSING
Practice Address - State:MA
Practice Address - Zip Code:02120-2847
Practice Address - Country:US
Practice Address - Phone:617-754-5800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAAH1966282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital