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Organization

WALTER S MOZDEN LO

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. WALTER S MOZDEN (OWNER)
(860) 889-9887
Entity
Organization

Contact information

Practice address
7 CLINIC DR, NORWICH, CT 06360-2915
(860) 889-9887
Mailing address
7 CLINIC DR, NORWICH, CT 06360-2915
(860) 889-9887

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
001299
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0187430001
MEDICARE
CT
01
100000818CT02
LUMENOS
CT
01
19796
SPECTERA
CT
Enumeration date
02/07/2008
Last updated
02/07/2008
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