Healthcare Provider Details

I. General information

NPI: 1194465419
Provider Name (Legal Business Name): ASHLEY SUSAN HARDEE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2022
Last Update Date: 08/12/2025
Certification Date: 08/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

223 CHIEF JUSTICE CUSHING HWY STE 201
COHASSET MA
02025-1391
US

IV. Provider business mailing address

223 CHIEF JUSTICE CUSHING HWY STE 201
COHASSET MA
02025-1391
US

V. Phone/Fax

Practice location:
  • Phone: 781-383-8380
  • Fax:
Mailing address:
  • Phone:
  • Fax: 781-383-8382

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number57.253008
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number1021986
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: