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Individual

SUZANNE PENDER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1153 CENTRE ST, RADIOLOGY FAULKNER HOSPITAL, BOSTON, MA 02130
(617) 983-7090
(617) 983-7091
Mailing address
1153 CENTRE ST, RADIOLOGY FAULKNER HOSPITAL, BOSTON, MA 02130
(617) 983-7090
(617) 983-7091

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
72463
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
072463
TUFTS
MA
05
3070808
MA
01
J10285
BLUE CROSS BLUE SHIELD
MA
Enumeration date
12/15/2005
Last updated
09/12/2012
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