Individual
SUSAN ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
133 BROOKLINE AVE, BOSTON, MA 02215-3904
(617) 421-1000
Mailing address
147 MILK ST, BOSTON, MA 02109-4806
(617) 421-2508
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0367711
—
MA
01
—
2430421-004
CIGNA
MA
01
—
CN0149
BCBS
MA
01
—
F914
HPHC
MA
Enumeration date
01/18/2007
Last updated
07/08/2007
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