Dr JONATHAN R MOLDOVER is a male medical professional, specializing in Physical Medicine And Rehabilitation. He graduated in 1974 from Columbia University College Of Physicians And Surgeons.
BAYSTATE MEDICAL PRACTICES INC
21 DWIGHT RD
105 BAYSTATE PHYSICAL MED N REHAB
LONGMEADOW
MA
011061765
Tel: 4137945600
| Npi | 1043215841 |
| Pac Id | 0244305423 |
| Professional Enrollment Id | I20150804005455 |
| Last Name | MOLDOVER |
| First Name | JONATHAN |
| Middle Name | R |
| Suffix | |
| Gender | M |
| Credential | |
| Medical School Name | COLUMBIA UNIVERSITY COLLEGE OF PHYSICIANS AND SURGEONS |
| Graduation Year | 1974 |
| Primary Specialty | PHYSICAL MEDICINE AND REHABILITATION |
| Secondary Specialty 1 | |
| Secondary Specialty 2 | |
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| Secondary Specialty 4 | |
| All Secondary Specialties | |
| Organization Legal Name | BAYSTATE MEDICAL PRACTICES INC |
| Group Practice Pac Id | 5991602971 |
| Number Of Group Practice Members | 899 |
| Line 1 Street Address | 21 DWIGHT RD |
| Line 2 Street Address | 105 BAYSTATE PHYSICAL MED N REHAB |
| Marker Of Address Line 2 Suppression | |
| City | LONGMEADOW |
| State | MA |
| Zip Code | 011061765 |
| Phone Number | 4137945600 |
| Hospital Affiliation Ccn 1 | 220077 |
| Hospital Affiliation Lbn 1 | BAYSTATE MEDICAL CENTER |
| Hospital Affiliation Ccn 2 | 220015 |
| Hospital Affiliation Lbn 2 | COOLEY DICKINSON HOSPITAL INC,THE |
| Hospital Affiliation Ccn 3 | |
| Hospital Affiliation Lbn 3 | |
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| Professional Accepts Medicare Assignment | Y |
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