Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RE0101X | Endocrinologist (Diabetes Doctor) | 17248 | NH |
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | D70505 | MD |
NPI | 1093964850 |
---|---|
Provider Name | Susan Yuditskaya |
First Address | Bedford, MA 01730-2718 |
Second Address | Lebanon, NH 03756-1000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/09/2008 |
Last Update Date | 12/01/2022 |