Individual
DR. JENNIFER D MOODIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
55 LAKE AVE N, DEPARTMENT OF NEUROLOGY, WORCESTER, MA 01655-0002
(508) 793-6566
(774) 442-9122
Mailing address
PO BOX 415348, NOSTON, MA 02241-5348
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
231408
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110077478A
—
MA
Enumeration date
07/19/2007
Last updated
02/25/2025
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