Basic Information
| Provider Information | |||||||||
| NPI: | 1548336340 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GULESIAN | ||||||||
| FirstName: | SUSAN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5 ZIONS LN | ||||||||
| Address2: | |||||||||
| City: | SHERBORN | ||||||||
| State: | MA | ||||||||
| PostalCode: | 017701323 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5086554151 | ||||||||
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| Practice Location | |||||||||
| Address1: | 298 HOWARD STREET | ||||||||
| Address2: | STE 100 | ||||||||
| City: | FRAMINGHAM | ||||||||
| State: | MA | ||||||||
| PostalCode: | 01752 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5088792250 | ||||||||
| FaxNumber: | 5086202637 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/27/2006 | ||||||||
| LastUpdateDate: | 03/17/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | 35829 | MA | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
ID Information
| ID | Type | State | Issuer | Description | 35829 | 01 | MA | BOARD OF REGISTRATION IN MEDICINE | OTHER |