Individual
DR. SUSAN A CONNOLLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
300 LONGWOOD AVE, BOSTON, MA 02115-5724
(617) 355-6286
Mailing address
300 LONGWOOD AVE, BOSTON, MA 02115-5724
(617) 355-6000
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
57608
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3101177
—
MA
Enumeration date
10/31/2006
Last updated
08/20/2007
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