Grondin, Suzanne Mattos
Grondin, Suzanne Mattos is an individual health care provider with primary practice located at 123 Summer St Suite 550, Worcester MA 01608-1216. She recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as her primary health care specialty. Grondin, Suzanne Mattos can be contacted via phone (508) 363-6868.Contact Information
Primary practice address
123 Summer St Suite 550
Worcester MA 01608-1216
Phone: (508) 363-6868
Fax: (508) 363-6866
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Podiatric Medicine & Surgery Service Providers / Podiatrist | 213E00000X | 2319 | Massachusetts |
Profile Details
| NPI number | 1639217276 |
|---|---|
| LBN Legal business name | Grondin, Suzanne Mattos |
| Credentials | Doctor of Podiatric Medicine (DPM) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 4th, 2007 |
| Last updated | Apr 25th, 2016 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1639217276 | NPPES |
| Massachusetts | MEDICAID | 0711772 | |
| Massachusetts | Other | 121815 | |
| Massachusetts | Other | Y71137 | |
| Massachusetts | Other | 466883 | |
| Massachusetts | Other | AA84858 |
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