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NPI Code Detail

MEDICARE: FRESH POND NEUROPSYCHOLOGY PLLC

MEDICARE: FRESH POND NEUROPSYCHOLOGY PLLC
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
1103TC0700XClinical Psychologist

General Provider Information

NPI Number : 1770384471
Entity Type Code : Organization
Provider Name (Legal Business Name) : FRESH POND NEUROPSYCHOLOGY PLLC
Provider Business Mailing Address
First Line : 725 CONCORD AVE STE 2100
Second Line :
City : CAMBRIDGE
State : MA
Zip : 02138-1052
Country : US
Telephone Number : 617-297-2221
Fax Number :
Provider Business Practice Location Address
First Line : 725 CONCORD AVE
Second Line :
City : CAMBRIDGE
State : MA
Zip : 02138-1040
Country : US
Telephone Number : 781-591-2884
Fax Number :
Authorized Official
Title or Position : NEUROPSYCHOLOGIST
Name : DR. JOCELYN A WINZER
Credential : PH.D.
Telephone Number : 617-480-0180
Provider Enumeration Date : 03/20/2025
Last Update Date : 04/29/2026

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