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General NPI Number Information
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NPI Number | 1124088463
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Entity Type | Individual
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Provider Name | JENNIFER TODD M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/23/2006
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Last Update Date | 08/14/2019
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Provider Practice Location Address
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Address Line | 111 COLCHESTER AVE
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City | BURLINGTON
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State | VT
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Zip | 05401-1473
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Country | US
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Telephone | 802-847-8200
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Fax |
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Provider Business Mailing Address
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Address Line | 300 LONGWOOD AVE
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City | BOSTON
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State | MA
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Zip | 02115-5724
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Country | US
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Telephone | 617-355-7476
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Fax | 617-730-0194
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 221799
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 042.0014188
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License Number State | VT
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Taxonomy #3
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Taxonomy Code | 2080P0205X
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Taxonomy Name | Pediatric Endocrinology Physician
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License Number | 042.0014188
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License Number State | VT
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Taxonomy #4
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Taxonomy Code | 2080P0205X
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Taxonomy Name | Pediatric Endocrinology Physician
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License Number | 221799
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License Number State | MA
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