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Provider Information for 1194992834

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DR. VASSILIOS JAMES BEZZERIDES M.D., PH.D.

Gender: MALE

Individual NPI: 1194992834

Calendar   Last Updated:  2020-10-03
  Certification Date:  2020-09-17

Details

Name Value
NPI 1194992834
Enumeration Date 2008-05-12
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 300 LONGWOOD AVE CHILDREN'S HOSPITAL BOSTON, HOUSE STAFF LOUNGE
BOSTON, MA 02115-5724
United States

Phone: 617-355-6363 | Fax:
View Map External Link
Primary Practice Address 300 LONGWOOD AVE # ENDERS12
BOSTON, MA 02115-5724
United States

Phone: 617-919-4290 | Fax:
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 207RC0001X - Internal Medicine Clinical Cardiac Electrophysiology MA 239833
No 208000000X - Pediatrics MA 229151