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Individual

DR. SUSAN BETH LANDRY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
1 MONARCH PL, 10TH FLOOR, SPRINGFIELD, MA 01144-1099
(413) 734-2000
(413) 734-8000
Mailing address
1 MONARCH PL, 10TH FLOOR, SPRINGFIELD, MA 01144-1099
(413) 734-2000
(413) 734-8000

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
036-111312
IL
207Q00000X
Family Medicine Physician
Primary
234300
MA
207Q00000X
Family Medicine Physician
47484
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
17750357
MA
01
234300
MASS BORM LICENSE
MA
Enumeration date
08/23/2006
Last updated
10/09/2013
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