Provider Demographics
NPI:1528023751
Name:MOLINAR, P.C.
Entity Type:Organization
Organization Name:MOLINAR, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:A
Authorized Official - Last Name:MOLINAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:617-361-1390
Mailing Address - Street 1:891 HYDE PARK AVE
Mailing Address - Street 2:
Mailing Address - City:HYDE PARK
Mailing Address - State:MA
Mailing Address - Zip Code:02136-3267
Mailing Address - Country:US
Mailing Address - Phone:617-361-1390
Mailing Address - Fax:617-361-2773
Practice Address - Street 1:891 HYDE PARK AVE
Practice Address - Street 2:
Practice Address - City:HYDE PARK
Practice Address - State:MA
Practice Address - Zip Code:02136-3267
Practice Address - Country:US
Practice Address - Phone:617-361-1390
Practice Address - Fax:617-361-2773
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAMA79365207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9718800Medicaid
MA3186075Medicaid
MAY02884Medicare ID - Type UnspecifiedINDIVIDUAL
MA9718800Medicaid