Provider Demographics
NPI:1114385218
Name:SUSANNE CLARE
Entity Type:Organization
Organization Name:SUSANNE CLARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSANNE
Authorized Official - Middle Name:CATHERINE
Authorized Official - Last Name:CLARE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:978-774-6457
Mailing Address - Street 1:5 HICKORY LN
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:MA
Mailing Address - Zip Code:01833-1801
Mailing Address - Country:US
Mailing Address - Phone:978-774-6457
Mailing Address - Fax:
Practice Address - Street 1:5 HICKORY LN
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:MA
Practice Address - Zip Code:01833-1801
Practice Address - Country:US
Practice Address - Phone:978-774-6457
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-03
Last Update Date:2016-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN233886282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital