MEDICARE: UNEDRA MULEY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	18	CT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	18	OTHER	CT	PART OF LICENSE NUMBER

General Provider Information

NPI Number	:	1932813201
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	UNEDRA MULEY

Provider Business Mailing Address
First Line	:	107 HARPER AVE
Second Line	:
City	:	NEW HAVEN
State	:	CT
Zip	:	06515-1117
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	107 HARPER AVE
Second Line	:
City	:	NEW HAVEN
State	:	CT
Zip	:	06515-1117
Country	:	US
Telephone Number	:	203-489-2870
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/10/2023
Last Update Date	:	01/10/2023

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Directions to “ UNEDRA MULEY ” Practice Location

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