Individual
TAMARA AGHAMOLLA SUSSMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
450 BROOKLINE AVE, BOSTON, MA 02215-5450
(617) 632-5055
(617) 632-6727
Mailing address
450 BROOKLINE AVE, BOSTON, MA 02215-5450
(617) 632-5055
(617) 632-6727
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
57026465
OH
207RH0003X
Hematology & Oncology Physician
Primary
35.134308
OH
207RX0202X
Medical Oncology Physician
287462
MA
207RX0202X
Medical Oncology Physician
35.134308
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/22/2015
Last updated
07/13/2023
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