Susan Sabarre Bostrom, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

53578 Issued in MA

Practice address

112 Landseer St
West Roxbury, MA 02132-3437

Phone

(617) 686-9531

NPI assigned

Jun 16, 2009

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1245110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245110400000",
    "number": "1245467323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 LANDSEER ST",
            "city": "WEST ROXBURY",
            "state": "MA",
            "postal_code": "021323437",
            "telephone_number": "617-686-9531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 LANDSEER ST",
            "city": "WEST ROXBURY",
            "state": "MA",
            "postal_code": "021323437",
            "telephone_number": "617-686-9531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSTROM",
        "first_name": "SUSAN",
        "middle_name": "SABARRE",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-16",
        "last_updated": "2009-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MA",
            "license": "53578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sinthia Bonilla, DPT
• Cheryl R Borrelli, RN
• Boston VA Healthcare System
• Boston Vamc
• Boston Vamc
• Kerri A Bourgeois, D.M.D.
• Joey Boyer, RN 237173
• Alyson Mackenzie Bracken, P.A.
• Mary Ellen Brady, MS RT(T)
• Jill Elizabeth Braganca, MD

• Licensed Practical Nurse in West Roxbury, MA
• Providers in West Roxbury, MA by specialty
• Licensed Practical Nurse in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.