Healthcare Provider Details

I. General information

NPI: 1780365437
Provider Name (Legal Business Name): JULIANA MOLINA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2023
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

81 HIGHLAND AVE
SALEM MA
01970-2714
US

IV. Provider business mailing address

81 HIGHLAND AVE
SALEM MA
01970-2714
US

V. Phone/Fax

Practice location:
  • Phone: 978-744-5900
  • Fax:
Mailing address:
  • Phone: 978-744-5900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: