Basic Information
| Provider Information | |||||||||
| NPI: | 1063730448 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ANDREWS | ||||||||
| FirstName: | SUZANNE | ||||||||
| MiddleName: | ELISABETH | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 700 ESSEX ST | ||||||||
| Address2: | |||||||||
| City: | LAWRENCE | ||||||||
| State: | MA | ||||||||
| PostalCode: | 018414396 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9786892400 | ||||||||
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| Practice Location | |||||||||
| Address1: | 700 ESSEX ST | ||||||||
| Address2: | |||||||||
| City: | LAWRENCE | ||||||||
| State: | MA | ||||||||
| PostalCode: | 018414396 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9786892400 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/11/2010 | ||||||||
| LastUpdateDate: | 01/18/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | MT197011 | PA | N | Hospitals | General Acute Care Hospital | 207Q00000X | MD448673 | PA | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | MD2013-0648 | NM | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 268805 | MA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.