Individual
SUSAN A MUJJUMBI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
29 GREENDALE AVE, WORCESTER, MA 01606-2229
(774) 253-0434
Mailing address
29 GREENDALE AVE, WORCESTER, MA 01606-2229
(774) 253-0434
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
LN87342
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000000
—
MA
Enumeration date
11/25/2022
Last updated
11/25/2022
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