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General NPI Number Information
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NPI Number | 1013195577
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Entity Type | Organization
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Legal Business Name | WALTER S MOZDEN LO
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Dates
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Enumeration Date | 02/07/2008
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Last Update Date | 02/07/2008
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Provider Practice Location Address
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Address Line | 7 CLINIC DR
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City | NORWICH
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State | CT
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Zip | 06360-2915
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Country | US
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Telephone | 860-889-9887
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Fax |
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Provider Business Mailing Address
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Address Line | 7 CLINIC DR
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City | NORWICH
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State | CT
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Zip | 06360-2915
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Country | US
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Telephone | 860-889-9887
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. WALTER S MOZDEN
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Credential |
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Telephone | 860-889-9887
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 001299
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License Number State | CT
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