Provider Demographics
NPI:1467443135
Name:HSU, KATHERINE K (MD, MPH)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:K
Last Name:HSU
Suffix:
Gender:F
Credentials:MD, MPH
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Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:720 HARRISON AVE
Mailing Address - Street 2:DOB 503
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-2371
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:850 HARRISON AVE
Practice Address - Street 2:YACC5
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118-4001
Practice Address - Country:US
Practice Address - Phone:617-414-4841
Practice Address - Fax:617-414-7230
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2014-07-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA156985208000000X, 2080P0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110060935AMedicaid
MA110060935AMedicaid