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Individual

DR. SANDRA VERONICA SUDUIKIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1575 CAMBRIDGE ST, CAMBRIDGE, MA 02138-4308
(617) 876-4344
Mailing address
55 FRUIT ST, BOSTON, MA 02114-2621
(617) 349-5706

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA76458
MA
208100000X
Physical Medicine & Rehabilitation Physician
76458
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
022064
CHAMPUS
MA
01
133800
HEALTHSOURCE
MA
05
3097501
MA
01
725372
TUFTS
MA
01
80137
HARVARD PILGRIM
MA
01
J12920
BLUE CROSS BLUE SHIELD
MA
01
S022064
TRICARE
MA
Enumeration date
06/08/2006
Last updated
12/17/2024
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