Provider Demographics
NPI:1003881772
Name:MOLTEN, AMY LEE (MD)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:LEE
Last Name:MOLTEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 WASHINGTON STREET, BOX 7051
Mailing Address - Street 2:TUFTS MEDICAL CENTER-FLOATING HOSPITAL FOR CHILDREN
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02111
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:800 WASHINGTON STREET, BOX 7051
Practice Address - Street 2:TUFTS MEDICAL CENTER-FLOATING HOSPITAL FOR CHILDREN
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02111
Practice Address - Country:US
Practice Address - Phone:617-636-5314
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-17
Last Update Date:2011-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT043168208000000X
MA246846208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics