Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 042.0014188 | VT |
N | 208000000X | Pediatrician | 221799 | MA |
Y | 2080P0205X | Pediatric Endocrinologist | 042.0014188 | VT |
N | 2080P0205X | Pediatric Endocrinologist | 221799 | MA |
NPI | 1124088463 |
---|---|
Provider Name | Dr. Jennifer Todd |
First Address | Boston, MA 02115-5724 |
Second Address | Burlington, VT 05401-1473 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2006 |
Last Update Date | 14/08/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
010221799MA01 | BCBC OF CONN (01) | MA |
2080729 | (05) | MA |
221799 | CONNECTICARE (01) | MA |
34849 | HEALTH NEW ENGLAND (01) | MA |
7857 | HEALTHNET (01) | MA |
AA15755 | PILGRIM (01) | MA |
J28024 | BCBS (01) | MA |