Provider Demographics
NPI:1053557421
Name:BOSTON EMERGENCY SERVICES TEAM NORTH SUFFOLK
Entity type:Organization
Organization Name:BOSTON EMERGENCY SERVICES TEAM NORTH SUFFOLK
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:FISHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-638-4920
Mailing Address - Street 1:85 E NEWTON ST
Mailing Address - Street 2:6TH FLOOR, BEST NORTH SUFFOLK
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-2340
Mailing Address - Country:US
Mailing Address - Phone:617-638-4920
Mailing Address - Fax:617-414-1975
Practice Address - Street 1:85 E NEWTON ST
Practice Address - Street 2:M802
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118-2340
Practice Address - Country:US
Practice Address - Phone:617-638-4920
Practice Address - Fax:617-414-1975
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BOSTON MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-01-06
Last Update Date:2009-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care