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NPI Code Detail

MEDICARE: SUSAN SAUCEDO MD

MEDICARE: SUSAN SAUCEDO 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
1207Q00000XFamily Medicine Physician238412MA
2207R00000XInternal Medicine PhysicianA95136CA

General Provider Information

NPI Number : 1861551509
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN SAUCEDO MD
Provider Business Mailing Address
First Line : 287 WESTERN AVE
Second Line :
City : ALLSTON
State : MA
Zip : 02134-1010
Country : US
Telephone Number : 617-783-0500
Fax Number :
Provider Business Practice Location Address
First Line : 287 WESTERN AVE
Second Line :
City : ALLSTON
State : MA
Zip : 02134-1010
Country : US
Telephone Number : 617-783-0500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/08/2006
Last Update Date : 11/30/2021

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Directions to “ SUSAN SAUCEDO MD” Practice Location

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