Healthcare Provider Details

I. General information

NPI: 1912322231
Provider Name (Legal Business Name): LINDSAY ALEXANDRA ZODDA FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/24/2014
Last Update Date: 02/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 PARKER HILL AVE
BOSTON MA
02120-2847
US

IV. Provider business mailing address

125 PARKER HILL AVE
BOSTON MA
02120-2847
US

V. Phone/Fax

Practice location:
  • Phone: 617-754-5800
  • Fax:
Mailing address:
  • Phone: 617-754-5800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN277054
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: