Provider Demographics
NPI:1841497856
Name:CARITAS CARNEY HOSPITAL
Entity type:Organization
Organization Name:CARITAS CARNEY HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MS
Authorized Official - First Name:ELIZABETH CONLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:CONLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:617-296-4012
Mailing Address - Street 1:20 PRESCOTT ST
Mailing Address - Street 2:APT. 44
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02138-3935
Mailing Address - Country:US
Mailing Address - Phone:617-497-7421
Mailing Address - Fax:617-474-3853
Practice Address - Street 1:2100 DORCHESTER AVE
Practice Address - Street 2:CARNEY HOSPITAL WOMEN'S CLINIC FOR HEALTH AND SAFETY
Practice Address - City:DORCHESTER CENTER
Practice Address - State:MA
Practice Address - Zip Code:02124-5615
Practice Address - Country:US
Practice Address - Phone:617-296-4012
Practice Address - Fax:617-474-3853
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-02
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA103332282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital