Provider Demographics
NPI:1124283205
Name:RICARDO A. MUJICA, MD, LLC
Entity type:Organization
Organization Name:RICARDO A. MUJICA, MD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RICARDO
Authorized Official - Middle Name:A
Authorized Official - Last Name:MUJICA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:413-262-6920
Mailing Address - Street 1:10 KNOX CIR
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01085-4586
Mailing Address - Country:US
Mailing Address - Phone:413-262-6920
Mailing Address - Fax:
Practice Address - Street 1:10 KNOX CIR
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:MA
Practice Address - Zip Code:01085-4586
Practice Address - Country:US
Practice Address - Phone:413-262-6920
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-28
Last Update Date:2009-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty