Individual
SUSANNE DAY KENAGY SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
450 BROOKLINE AVE, BOSTON, MA 02215-5418
(617) 632-3861
Mailing address
450 BROOKLINE AVE, BOSTON, MA 02215-5418
(617) 632-3861
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA3933
MA
363AM0700X
Medical Physician Assistant
002973
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1639400138
ANTHEM BCBS
CT
Enumeration date
01/22/2010
Last updated
08/14/2015
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