Healthcare Provider Details

I. General information

NPI: 1851497028
Provider Name (Legal Business Name): SUSAN CARY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2006
Last Update Date: 06/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 CONGRESS ST
SPRINGFIELD MA
01104-3564
US

IV. Provider business mailing address

PO BOX 291943
NASHVILLE TN
37229-1943
US

V. Phone/Fax

Practice location:
  • Phone: 413-732-0040
  • Fax: 615-237-1434
Mailing address:
  • Phone: 833-953-0829
  • Fax: 615-237-1434

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number420014270
License Number StateVT
# 2
Primary TaxonomyN
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License NumberC1-0012965
License Number StateDE
# 3
Primary TaxonomyY
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number73294
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: