Edgar P. Benjamin Healthcare Center, Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0785 Issued in MA

Legal business name

EDGAR P. BENJAMIN HEALTHCARE CENTER, INC

Practice address

120 Fisher Avenue
Boston, MA 02120-3320

Phone

(617) 738-1500

NPI assigned

May 2, 2007

Last updated

Feb 17, 2012By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Myrna E. Wynn, PRESIDENT & CEO

Title

Administrator

Phone

(617) 738-1500

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Resthaven Corporation Former legal business name

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329436800000",
    "number": "1932320215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 FISHER AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021203320",
            "telephone_number": "617-738-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 FISHER AVENUE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021203320",
            "telephone_number": "617-738-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDGAR P. BENJAMIN HEALTHCARE CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-02",
        "last_updated": "2012-02-17",
        "status": "A",
        "authorized_official_last_name": "WYNN",
        "authorized_official_first_name": "MYRNA",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "617-738-1500",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PRESIDENT & CEO"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MA",
            "license": "0785",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0998613",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Resthaven Corporation",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Marc Michael Edelstein, M.D.
• Morris Scott Edelstein, DDS
• Katrina Eder, CPN
• Judith Gallen Edersheim, MD
• Edgar P Benjamin Healthcare Center, Inc (Benjamin Healthcare Center)
• Tara Edgens, LABA
• Edgewater Psychiatry, PLLC
• Chloe Angelina Edgington
• Jordan Leigh Edgren, MD
• Edith Ortiz, Licsw

• Skilled Nursing Facility in Boston, MA
• Providers in Boston, MA by specialty
• Skilled Nursing Facility in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.