Individual
JENNIFER MODLISZEWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1611 CAMBRIDGE ST, CAMBRIDGE, MA 02138-4302
(617) 661-5500
Mailing address
1611 CAMBRIDGE ST, CAMBRIDGE, MA 02138-4302
(931) 980-2555
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
2274129
MA
363LA2200X
Adult Health Nurse Practitioner
Primary
RN2274129
MA
Other
Enumeration date
12/28/2012
Last updated
09/30/2021
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