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Organization

UNITED STATES NAVY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JAMES J MUCCIARONE M.D. (COMMANDER / OIC NAVAL UNDERSEA MED)
(860) 694-6483
Entity
Organization

Contact information

Practice address
1 CRYSTAL LAKE RD, BLDG 159 NAVAL UNDERSEA MEDICAL INST. NAVSUBASE NLON, GROTON, CT 06349-2300
(860) 694-6483
Mailing address
1 CRYSTAL LAKE ROAD, BLDG 159 NAVAL UNDERSEA MEDICAL INST. NAVSUBASE NLON, GROTON, CT 06340

Taxonomy

Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary

Other

Enumeration date
09/01/2016
Last updated
09/01/2016
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