Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 71207 | MA |
NPI | 1013974492 |
---|---|
Provider Name | Susan Celia Hellerstein |
First Address | Chestnut Hill, MA 02467-2477 |
Second Address | Brookline, MA 02445-6002 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/04/2006 |
Last Update Date | 29/06/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3063828 | (05) | MA |