DR. MOLLY TRACY M.D. NPI 1124210968

NPI Information

  • NPI: 1124210968
  • Provider Name: DR. MOLLY TRACY, M.D.
  • Classification: Psychiatry & Neurology - 2084N0402X
  • Specialization: Neurology with Special Qualifications in Child Neurology
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 300 LONGWOOD AVE
    FEGAN 11
    BOSTON, MA
    ZIP 02115
  • Phone: (617) 355-6388

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NPI Details

DR. Molly Tracy, M.D. is a neurology with special qualifications in child neurology psychiatry neurology in Boston, MA with 22 years of experience. The provider is a Child Neurologist specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, early childhood, and adolescence. DR. Molly Tracy, M.D. NPI is 1124210968. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: UNIVERSITY OF MINNESOTA MEDICAL SCHOOL
Graduation Year:2003

The provider's business location address is:

300 LONGWOOD AVE
FEGAN 11
BOSTON, MA
ZIP 02115-724
Phone: (617) 355-6388

The NPI 1124210968 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/15/2007 and was last updated on 4/6/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12084N0402XPsychiatry & NeurologyNeurology with Special Qualifications in Child NeurologyMD13088RHODE ISLANDNo
22084N0402XPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology235420MASSACHUSETTSYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1110084585AMEDICAIDMASSACHUSETTS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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