Individual
KEVIN MUGNO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
100 CHURCH ST S, NEW HAVEN, CT 06519-1703
(203) 785-2860
Mailing address
101 N 69TH ST APT 20, OMAHA, NE 68132-2700
(916) 865-8416
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
10/10/2021
Last updated
10/10/2021
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