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Individual

CHANA S WASSERMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
77 MASS AVE, MEDICAL E23-395, CAMBRIDGE, MA 02139-4301
(617) 253-0556
Mailing address
PO BOX 425789, MEDICAL E23-395, CAMBRIDGE, MA 02142-0015
(617) 253-0556

Taxonomy

Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
154463
MA
207VX0000X
Obstetrics Physician
Primary
154463
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
J24463
BLUE CROSS
MA
Enumeration date
02/10/2006
Last updated
04/17/2012
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