Provider Demographics
NPI:1336139468
Name:JONES, ROBIN MOIRA (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:MOIRA
Last Name:JONES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 9142
Mailing Address - Street 2:MASS GENERAL PHYSICIAN ORGANIZATION
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-9142
Mailing Address - Country:US
Mailing Address - Phone:617-726-3402
Mailing Address - Fax:617-726-2353
Practice Address - Street 1:55 FRUIT ST
Practice Address - Street 2:YAW 6-6B
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2621
Practice Address - Country:US
Practice Address - Phone:617-726-3402
Practice Address - Fax:617-726-2353
Is Sole Proprietor?:No
Enumeration Date:2005-10-28
Last Update Date:2012-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA77433208000000X, 2084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ14241OtherBCBS MA
MA077433OtherTUFTS HEALTH PLAN
MA3118487Medicaid
MAJ14241OtherBCBS MA
MAJ14241Medicare ID - Type Unspecified