Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | 222794 | MA |
NPI | 1275579237 |
---|---|
Provider Name | Suzanne Shusterman |
First Address | Boston, MA 02115 |
Second Address | Boston, MA 02115 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2076951 | (05) | MA |
222794 | TUFTS (01) | |
6136134 | CIGNA (01) | |
AA20281 | HPHC DFCI ONLY (01) | |
H15006 | (02) |