Provider Demographics
NPI:1598408809
Name:MOULI ASSOCIATES LLC
Entity Type:Organization
Organization Name:MOULI ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SATYARANI
Authorized Official - Middle Name:
Authorized Official - Last Name:TALLAPUREDDY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:860-471-8030
Mailing Address - Street 1:216 HEMLOCK AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:SOUTH WINDSOR
Mailing Address - State:CT
Mailing Address - Zip Code:06074-9607
Mailing Address - Country:US
Mailing Address - Phone:860-471-8030
Mailing Address - Fax:860-244-9143
Practice Address - Street 1:216 HEMLOCK AVE STE 103
Practice Address - Street 2:
Practice Address - City:SOUTH WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06074-9607
Practice Address - Country:US
Practice Address - Phone:860-471-8030
Practice Address - Fax:860-244-9143
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-14
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty