Provider Demographics
NPI:1528089992
Name:BURCHMAN, SUZANNE (MED, RD, LDN)
Entity type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:
Last Name:BURCHMAN
Suffix:
Gender:F
Credentials:MED, RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 73
Mailing Address - Street 2:
Mailing Address - City:HOPKINTON
Mailing Address - State:MA
Mailing Address - Zip Code:01748-0073
Mailing Address - Country:US
Mailing Address - Phone:508-361-4588
Mailing Address - Fax:
Practice Address - Street 1:605 LINCOLN ST
Practice Address - Street 2:VETERANS ADMINISTRATION OUTPATIENT CLINIC
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605-1901
Practice Address - Country:US
Practice Address - Phone:508-856-0104
Practice Address - Fax:508-856-7425
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA636133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered