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Provider Information for 1720056096

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

CONSTANCE S HOUCK MD

Gender: FEMALE

Individual NPI: 1720056096

Calendar   Last Updated:  2007-08-20
  Certification Date: 

Details

Name Value
NPI 1720056096
Enumeration Date 2006-03-10
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 300 LONGWOOD AVE
BOSTON, MA 02115-5724
United States

Phone: 617-355-6457 | Fax:
View Map External Link
Primary Practice Address 300 LONGWOOD AVE BADER 3
BOSTON, MA 02115-5724
United States

Phone: 617-355-6457 | Fax:
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
MEDICAID MA 3107353
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 207L00000X - Anesthesiology MA 75392
No 207LP2900X - Anesthesiology Pain Medicine MA 75392
No 208000000X - Pediatrics MA 75392
No 2080P0203X - Pediatrics Pediatric Critical Care Medicine MA 75392