Healthcare Provider Details

I. General information

NPI: 1215992995
Provider Name (Legal Business Name): DEBORAH L MARSDEN MBBS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2006
Last Update Date: 08/21/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 LONGWOOD AVE CHILDREN'S HOSPITAL BOSTON
BOSTON MA
02115
US

IV. Provider business mailing address

300 LONGWOOD AVE CHILDREN'S HOSPITAL BOSTON
BOSTON MA
02115
US

V. Phone/Fax

Practice location:
  • Phone: 617-355-4695
  • Fax:
Mailing address:
  • Phone: 617-355-4695
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207SG0202X
TaxonomyClinical Biochemical Genetics Physician
License Number82059
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number82059
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: