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General NPI Number Information
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NPI Number | 1366394777
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Entity Type | Individual
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Provider Name | DZENIS MUJANOVIC
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Gender |
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Dates
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Enumeration Date | 02/10/2026
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Last Update Date | 02/10/2026
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Provider Practice Location Address
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Address Line | 249 GLENWOOD RD BLDG 1
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City | BINGHAMTON
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State | NY
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Zip | 13905-1603
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Country | US
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Telephone | 607-296-3072
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Fax |
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Provider Business Mailing Address
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Address Line | 518 JAMES ST
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City | SYRACUSE
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State | NY
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Zip | 13203-2238
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Country | US
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Telephone |
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Fax |
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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