Provider Demographics
NPI:1467463455
Name:DUMOND, CAROL MANCINI (DC)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:MANCINI
Last Name:DUMOND
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:CAROL
Other - Middle Name:
Other - Last Name:MANCINI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:440 MAIN ST S
Mailing Address - Street 2:
Mailing Address - City:SOUTHBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06488-4201
Mailing Address - Country:US
Mailing Address - Phone:203-262-6347
Mailing Address - Fax:203-267-6155
Practice Address - Street 1:440 MAIN ST S
Practice Address - Street 2:
Practice Address - City:SOUTHBURY
Practice Address - State:CT
Practice Address - Zip Code:06488-4201
Practice Address - Country:US
Practice Address - Phone:203-262-6347
Practice Address - Fax:203-267-6155
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000765111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTU01931Medicare UPIN
CT350000562Medicare ID - Type Unspecified