Individual
JENNIFER CHILDS-ROSHAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
133 BROOKLINE AVE, INTERNAL MEDICINE, BOSTON, MA 02215-3904
(617) 421-5804
(617) 421-8865
Mailing address
133 BROOKLINE AVE, INTERNAL MEDICINE, BOSTON, MA 02215-3904
(617) 421-5804
(617) 421-8865
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
210324
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2024161
—
MA
Enumeration date
07/12/2006
Last updated
12/13/2012
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