Provider Demographics
NPI:1083681563
Name:BLOCK, SUSAN D (MD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:D
Last Name:BLOCK
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:44 BINNEY ST
Mailing Address - Street 2:SW411
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-6013
Mailing Address - Country:US
Mailing Address - Phone:617-632-6181
Mailing Address - Fax:617-632-6180
Practice Address - Street 1:44 BINNEY ST
Practice Address - Street 2:SW411
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-6013
Practice Address - Country:US
Practice Address - Phone:617-632-6181
Practice Address - Fax:617-632-6180
Is Sole Proprietor?:No
Enumeration Date:2006-03-03
Last Update Date:2007-08-14
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Provider Licenses
StateLicense IDTaxonomies
MA434202084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
2488260OtherCIGNA
MAV05389OtherBLUE CROSS BLUE SHIELD
V05389OtherBC ELECT
702287OtherTUFTS
260038158OtherRR MEDICARE DFCI
154534OtherHPHC DFCI ONLY
260038156OtherRR MEDICARE BINNEY MED
V05389OtherINDEMNITY
MA0163996Medicaid
V05389OtherHMO BLUE
65517OtherFALLON COMM HEALTH PLAN
2488260OtherCIGNA
MA0163996Medicaid