Basic Information
| Provider Information | |||||||||
| NPI: | 1831281344 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SUMAN | ||||||||
| FirstName: | DENNIS | ||||||||
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| Credential: | PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 55 HIGHLAND AVE | ||||||||
| Address2: | SUITE 201 | ||||||||
| City: | SALEM | ||||||||
| State: | MA | ||||||||
| PostalCode: | 019702100 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9787456601 | ||||||||
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| Practice Location | |||||||||
| Address1: | 55 HIGHLAND AVE | ||||||||
| Address2: | SUITE 201 | ||||||||
| City: | SALEM | ||||||||
| State: | MA | ||||||||
| PostalCode: | 019702100 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9787456601 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/29/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | PA2005 | MA | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.