Provider Demographics
NPI:1013974492
Name:HELLERSTEIN, SUSAN CELIA (MD)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:CELIA
Last Name:HELLERSTEIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 BOYLSTON ST
Mailing Address - Street 2:FISH WOMEN'S HEALTH CENTER
Mailing Address - City:CHESTNUT HILL
Mailing Address - State:MA
Mailing Address - Zip Code:02467-2477
Mailing Address - Country:US
Mailing Address - Phone:617-732-9300
Mailing Address - Fax:
Practice Address - Street 1:111 CYPRESS ST
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02445-6002
Practice Address - Country:US
Practice Address - Phone:857-307-0896
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-28
Last Update Date:2012-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA71207207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3063828Medicaid