Provider Demographics
NPI:1902391022
Name:MOLINA, EMILY CLAIRE (DO, MSPH)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:CLAIRE
Last Name:MOLINA
Suffix:
Gender:F
Credentials:DO, MSPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 E OLNEY AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19120-2470
Mailing Address - Country:US
Mailing Address - Phone:215-456-1825
Mailing Address - Fax:215-456-5926
Practice Address - Street 1:401 TOWNSHIP LINE RD STE B
Practice Address - Street 2:
Practice Address - City:ELKINS PARK
Practice Address - State:PA
Practice Address - Zip Code:19027-2277
Practice Address - Country:US
Practice Address - Phone:484-622-6520
Practice Address - Fax:484-622-6530
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-30
Last Update Date:2021-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
PAOS021308208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program