Healthcare Provider Details

I. General information

NPI: 1245368406
Provider Name (Legal Business Name): JEREMI MOSS CARSWELL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2007
Last Update Date: 06/30/2025
Certification Date: 06/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BOSTON CHILDREN'S HOSPITAL - ENDOCRINOLOGY 300 LONGWOOD AVENUE
BOSTON MA
02115
US

IV. Provider business mailing address

BOSTON CHILDREN'S HOSPITAL - ENDOCRINOLOGY 300 LONGWOOD AVENUE
BOSTON MA
02115
US

V. Phone/Fax

Practice location:
  • Phone: 617-355-4367
  • Fax: 617-730-6216
Mailing address:
  • Phone: 508-341-7522
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080S0010X
TaxonomyPediatric Sports Medicine Physician
License Number216541
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number216541
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License Number216541
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: