Provider Demographics
NPI:1639529282
Name:MURLJACIC, CONCETTA (MSC(A))
Entity Type:Individual
Prefix:MRS
First Name:CONCETTA
Middle Name:
Last Name:MURLJACIC
Suffix:
Gender:F
Credentials:MSC(A)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 GLENVILLE ST
Mailing Address - Street 2:
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06831-4140
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1150 SUMMER ST
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06905-5530
Practice Address - Country:US
Practice Address - Phone:203-324-1880
Practice Address - Fax:203-324-4390
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-14
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003497235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist