Tracy, Molly
Tracy, Molly is an individual health care provider with primary practice located at 300 Longwood Ave Fegan 11, Boston MA 02115-5724. She recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology with Special Qualifications in Child Neurology, which is considered as her primary health care specialty. Tracy, Molly can be contacted via phone (617) 355-6388.Contact Information
Primary practice address
300 Longwood Ave Fegan 11
Boston MA 02115-5724
Phone: (617) 355-6388
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neurology with Special Qualifications in Child Neurology | 2084N0402X | 235420 | Massachusetts |
| Allopathic & Osteopathic Physicians / Neurology with Special Qualifications in Child Neurology | 2084N0402X | MD13088 | Rhode Island |
Profile Details
| NPI number | 1124210968 |
|---|---|
| LBN Legal business name | Tracy, Molly |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 15th, 2007 |
| Last updated | Apr 6th, 2017 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1124210968 | NPPES |
| Massachusetts | MEDICAID | 110084585A |
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