Basic Information
| Provider Information | |||||||||
| NPI: | 1154574036 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DEMARTINI | ||||||||
| FirstName: | ELIZABETH | ||||||||
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| Credential: | N.P | ||||||||
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| Mailing Information | |||||||||
| Address1: | 330 BROOKLINE AVE BETH ISRAEL DEACONESS MEDICAL CENTER | ||||||||
| Address2: | ANESTHESIA, CRITICAL CARE AND PAIN MEDICINE YAMINS 219 | ||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 022155400 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6176673364 | ||||||||
| FaxNumber: | 6176675013 | ||||||||
| Practice Location | |||||||||
| Address1: | 330 BROOKLINE AVE | ||||||||
| Address2: | ANESTHESIA, CRITICAL CARE AND PAIN MEDICINE YAMINS 219 | ||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 022155400 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6176673364 | ||||||||
| FaxNumber: | 6176675013 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/23/2008 | ||||||||
| LastUpdateDate: | 01/13/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/13/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | RN2277569 | MA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered | 363LA2100X | RN2277569 | MA | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care |
No ID Information.