Provider Demographics
NPI:1487708962
Name:MUJUMDAR, RENU (MA)
Entity type:Individual
Prefix:MRS
First Name:RENU
Middle Name:
Last Name:MUJUMDAR
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:178 MERRIMACK MEADOWS LN
Mailing Address - Street 2:
Mailing Address - City:TEWKSBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01876-1085
Mailing Address - Country:US
Mailing Address - Phone:978-455-8965
Mailing Address - Fax:
Practice Address - Street 1:530 BORDER ST
Practice Address - Street 2:
Practice Address - City:EAST BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02128-2432
Practice Address - Country:US
Practice Address - Phone:617-569-6560
Practice Address - Fax:617-569-1856
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator