Healthcare Provider Details

I. General information

NPI: 1528023751
Provider Name (Legal Business Name): MOLINAR, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

891 HYDE PARK AVE
HYDE PARK MA
02136-3267
US

IV. Provider business mailing address

891 HYDE PARK AVE
HYDE PARK MA
02136-3267
US

V. Phone/Fax

Practice location:
  • Phone: 617-361-1390
  • Fax: 617-361-2773
Mailing address:
  • Phone: 617-361-1390
  • Fax: 617-361-2773

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMA79365
License Number StateMA

VIII. Authorized Official

Name: DR. JOSE A MOLINAR
Title or Position: DIRECTOR
Credential: M.D.
Phone: 617-361-1390