Healthcare Provider Details

I. General information

NPI: 1619883055
Provider Name (Legal Business Name): SUSANA P GAUD DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27 E MAIN ST
WEBSTER MA
01570-2310
US

IV. Provider business mailing address

27 E MAIN ST
WEBSTER MA
01570-2310
US

V. Phone/Fax

Practice location:
  • Phone: 508-943-8895
  • Fax: 508-949-2187
Mailing address:
  • Phone: 508-943-8895
  • Fax: 508-949-2187

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number5260
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: