Provider Demographics
NPI:1578108726
Name:CHOQUETTE, SUZANNE ELISE
Entity Type:Individual
Prefix:MS
First Name:SUZANNE
Middle Name:ELISE
Last Name:CHOQUETTE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 COMMONWEALTH RD
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02472-1318
Mailing Address - Country:US
Mailing Address - Phone:617-717-8410
Mailing Address - Fax:
Practice Address - Street 1:24 CHURCH ST
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:MA
Practice Address - Zip Code:02472-3851
Practice Address - Country:US
Practice Address - Phone:617-717-8410
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-12
Last Update Date:2019-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist