MEDICARE: CHRISTOPHER JAMES MOLLICA MA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist

General Provider Information

NPI Number	:	1205588050
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER JAMES MOLLICA MA

Provider Business Mailing Address
First Line	:	77 WARREN ST BLDG 2
Second Line	:
City	:	BRIGHTON
State	:	MA
Zip	:	02135-3601
Country	:	US
Telephone Number	:	617-787-1901
Fax Number	:

Provider Business Practice Location Address
First Line	:	1135 CHARLES ST
Second Line	:
City	:	NORTH PROVIDENCE
State	:	RI
Zip	:	02904-3538
Country	:	US
Telephone Number	:	401-400-7745
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/24/2022
Last Update Date	:	04/12/2026

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