Individual
SUSAN MARY TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1 ESSEX CENTER DR, LAHEY CLINIC, PEABODY, MA 01960-2901
(978) 538-4400
(978) 538-4724
Mailing address
1 ESSEX CENTER DRIVE, LAHEY CLINIC, PEABODY, MA 01960-2901
(978) 538-4400
(978) 538-4724
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
156646
MA
207WX0200X
Ophthalmic Plastic and Reconstructive Surgery Physician
Primary
156646
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110059835A
—
MA
Enumeration date
09/26/2006
Last updated
05/04/2016
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