Provider Demographics
NPI:1982658720
Name:FREEDMAN, SUSAN S (RN CS)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:S
Last Name:FREEDMAN
Suffix:
Gender:F
Credentials:RN CS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:64 RIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:NEWTON CENTRE
Mailing Address - State:MA
Mailing Address - Zip Code:02459-2535
Mailing Address - Country:US
Mailing Address - Phone:617-965-5235
Mailing Address - Fax:617-527-0157
Practice Address - Street 1:2000 WASHINGTON ST
Practice Address - Street 2:SUITE 402
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02462-1650
Practice Address - Country:US
Practice Address - Phone:617-965-5235
Practice Address - Fax:617-527-0157
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA114131-PC163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAFRNS0300Medicare ID - Type Unspecified
MA588095Medicare UPIN