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NPI Code Detail

MEDICARE: DR. EDWARD E MULLEN MD

MEDICARE: DR. EDWARD E MULLEN MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialist172604NY
22085R0001XRadiation Oncology Physician172604-1NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1104824606
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. EDWARD E MULLEN MD
Provider Business Mailing Address
First Line : PO BOX 5670
Second Line :
City : HICKSVILLE
State : NY
Zip : 11802-5670
Country : US
Telephone Number : 516-632-3370
Fax Number : 516-336-2930
Provider Business Practice Location Address
First Line : 1 HEALTHY WAY
Second Line :
City : OCEANSIDE
State : NY
Zip : 11572-1551
Country : US
Telephone Number : 516-632-3303
Fax Number : 516-336-2930
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2005
Last Update Date : 02/14/2017

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Directions to “ DR. EDWARD E MULLEN MD” Practice Location

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