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General NPI Number Information
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NPI Number | 1356359152
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Entity Type | Individual
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Provider Name | RICARDO A MUJICA MD
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Gender | Male
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Dates
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Enumeration Date | 08/04/2006
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Last Update Date | 10/31/2008
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Provider Practice Location Address
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Address Line | 1132 WESTFIELD ST
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City | WEST SPRINGFIELD
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State | MA
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Zip | 01089-3878
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Country | US
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Telephone | 413-592-1980
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Fax | 413-439-0096
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Provider Business Mailing Address
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Address Line | 10 KNOX CIR
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City | WESTFIELD
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State | MA
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Zip | 01085-4586
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Country | US
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Telephone | 413-262-6920
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Fax | 413-568-2897
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0805X
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Taxonomy Name | Geriatric Psychiatry Physician
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License Number | 216641
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License Number State | MA
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