Provider Demographics
NPI:1518913151
Name:SUZUKI, BRUCE H (MD)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:H
Last Name:SUZUKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 BROOKLINE PL
Mailing Address - Street 2:SUITE 401
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02445-7224
Mailing Address - Country:US
Mailing Address - Phone:617-735-8855
Mailing Address - Fax:617-735-8864
Practice Address - Street 1:1 BROOKLINE PL
Practice Address - Street 2:SUITE 401
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02445-7224
Practice Address - Country:US
Practice Address - Phone:617-735-8855
Practice Address - Fax:617-735-8864
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2011-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA46041207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA19271OtherHARVARD PILGRIM
MA0110094Medicaid
MA046041OtherTUFTS
MA040004225OtherRAILROAD MEDICARE
MAC04864OtherBLUE SHIELD
MA19271OtherHARVARD PILGRIM
MAC04864OtherBLUE SHIELD