Provider Demographics
NPI:1700944519
Name:MOSUNIC, CHRISTOPHER J (PHD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:J
Last Name:MOSUNIC
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:4 DEARFIELD DRIVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06831-5351
Mailing Address - Country:US
Mailing Address - Phone:203-987-4620
Mailing Address - Fax:203-404-4832
Practice Address - Street 1:4 DEARFIELD DR
Practice Address - Street 2:SUITE 102
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06831-5351
Practice Address - Country:US
Practice Address - Phone:203-987-4620
Practice Address - Fax:203-404-4832
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2008-06-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY016419103TC0700X
CT002671103TC0700X
NY006043133V00000X
CT000715133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered