MEDICARE: DR. CINDY M KU MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	232089	MA

General Provider Information

NPI Number	:	1043451057
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CINDY M KU MD

Provider Business Mailing Address
First Line	:	1 DEACONESS RD
Second Line	:	ROOM CC-470
City	:	BOSTON
State	:	MA
Zip	:	02115-6007
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 DEACONESS RD
Second Line	:	ROOM CC-470
City	:	BOSTON
State	:	MA
Zip	:	02115-6007
Country	:	US
Telephone Number	:	617-754-2713
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/20/2009
Last Update Date	:	03/20/2009

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