Provider Demographics
NPI:1649658394
Name:MCGAHN, SUSAN JUDITH (NP)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:JUDITH
Last Name:MCGAHN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
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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 1:88 EAST NEWTON STREET
Practice Address - Street 2:H-2, BMC ARRHYTHMIA CENTER
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118-2908
Practice Address - Country:US
Practice Address - Phone:617-638-8776
Practice Address - Fax:617-414-8772
Is Sole Proprietor?:No
Enumeration Date:2015-05-14
Last Update Date:2015-12-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MARN217105363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner