Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 77433 | MA |
Y | 2084N0402X | Child Neurologist | 77433 | MA |
NPI | 1336139468 |
---|---|
Provider Name | Dr. Robin Moira Jones |
First Address | Charlestown, MA 02129-9142 |
Second Address | Boston, MA 02114-2621 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/10/2005 |
Last Update Date | 16/11/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
077433 | TUFTS HEALTH PLAN (01) | MA |
3118487 | (05) | MA |
F68356 | (02) | |
J14241 | BCBS MA (01) | MA |