Jennifer D. Moodie
Neurologist
55 Lake Ave N Department Of Neurology
Worcester
, Massachusetts 01655-0002
Jennifer D. Moodie
Neurologist
55 Lake Ave N Department Of Neurology
Worcester
, Massachusetts 01655-0002
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About
Features
Specialties
- Neurologist
Languages spoken
- English
Location
First Address
- Jennifer D. Moodie
- Po Box 415348
- Noston, MA
- Zip : 02241-5348
- Phone :
Second Address
- Jennifer D. Moodie
- 55 Lake Ave N Department Of Neurology
- Worcester, MA
- Zip : 01655-0002
- Fax : (774) 442-9122
- Phone : (508) 793-6566
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2084N0400X | Neurologist | 231408 | MA |
National Provider Identifier
| NPI | 1023218914 |
|---|---|
| Provider Name | Jennifer D. Moodie |
| First Address | Noston, MA 02241-5348 |
| Second Address | Worcester, MA 01655-0002 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 19/07/2007 |
| Last Update Date | 23/10/2020 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 110077478A | (05) | MA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.