Organization Name: | MEDICAL HYPNOSIS CENTER OF SANDY HOOK LLC |
NPI Number: | 1356710040 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOHN MATTHEW LUJANAC (MEMBER) |
Mailing Address: | 68 Walnut Tree Hill Rd Sandy Hook |
State: | CT US |
Postal Code: | 064821073 |
Phone Number: | 2032573130 |
Fax Number: | |
NPI Enumeration Date: | 09/23/2015 |
NPI Last Update Date: | 12/18/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 002370 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CT |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |