Individual
SUSAN P PERRINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
830 HARRISON AVE, MOAKLEY, 3RD FLOOR, BOSTON, MA 02118-2905
(617) 638-6428
(617) 638-5756
Mailing address
720 HARRISON AVE, DOB5, BOSTON, MA 02118
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
42952
MA
208000000X
Pediatrics Physician
42952
MA
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
42952
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110055287A
—
MA
Enumeration date
12/30/2005
Last updated
04/07/2014
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