Healthcare Provider Details

I. General information

NPI: 1730333477
Provider Name (Legal Business Name): FAITH VANDER LINDEN HSU NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: FAITH MICHELLE VANDER LINDEN

II. Dates (important events)

Enumeration Date: 11/07/2008
Last Update Date: 11/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 BROOKLINE AVE
BOSTON MA
02215-5400
US

IV. Provider business mailing address

330 BROOKLINE AVE
BOSTON MA
02215-5400
US

V. Phone/Fax

Practice location:
  • Phone: 617-754-2743
  • Fax: 617-754-2754
Mailing address:
  • Phone: 617-754-2743
  • Fax: 617-754-2754

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number280654
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: