Provider Demographics
NPI:1255720306
Name:MUCCI, JANET
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:MUCCI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 CHELSEA DR
Mailing Address - Street 2:
Mailing Address - City:MERRICK
Mailing Address - State:NY
Mailing Address - Zip Code:11566-2005
Mailing Address - Country:US
Mailing Address - Phone:516-867-1491
Mailing Address - Fax:
Practice Address - Street 1:7 CHELSEA DR
Practice Address - Street 2:
Practice Address - City:MERRICK
Practice Address - State:NY
Practice Address - Zip Code:11566-2005
Practice Address - Country:US
Practice Address - Phone:516-867-1491
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-13
Last Update Date:2015-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist