MEDICARE: SUSAN YANOW

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	104100000X	Social Worker	101967	MA

General Provider Information

NPI Number	:	1659858538
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN YANOW

Provider Business Mailing Address
First Line	:	221 NORFOLK ST
Second Line	:
City	:	CAMBRIDGE
State	:	MA
Zip	:	02139-1402
Country	:	US
Telephone Number	:	161-749-2115
Fax Number	:

Provider Business Practice Location Address
First Line	:	221 NORFOLK ST
Second Line	:
City	:	CAMBRIDGE
State	:	MA
Zip	:	02139-1402
Country	:	US
Telephone Number	:	161-749-2115
Fax Number	:

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

Provider Enumeration Date	:	07/24/2018
Last Update Date	:	07/24/2018

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Directions to “ SUSAN YANOW ” Practice Location

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