Provider Demographics
NPI:1407273824
Name:JAMES D MULLANE ND LLC
Entity Type:Organization
Organization Name:JAMES D MULLANE ND LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:MULLANE
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:203-942-4797
Mailing Address - Street 1:72 NORTH ST
Mailing Address - Street 2:STE 100A
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810-5648
Mailing Address - Country:US
Mailing Address - Phone:203-942-4797
Mailing Address - Fax:
Practice Address - Street 1:72 NORTH ST
Practice Address - Street 2:STE 100A
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-5648
Practice Address - Country:US
Practice Address - Phone:203-942-4797
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-24
Last Update Date:2014-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000299175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Single Specialty