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NPI Code Detail

MEDICARE: PMM MEDICAL PC

MEDICARE: PMM MEDICAL PC
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
1208000000XPediatrics Physician207493NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2207493OTHERNYNYS LICENSE

General Provider Information

NPI Number : 1487794228
Entity Type Code : Organization
Provider Name (Legal Business Name) : PMM MEDICAL PC
Provider Business Mailing Address
First Line : 10406 FLATLANDS AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11236-2806
Country : US
Telephone Number : 718-649-9930
Fax Number : 718-649-9931
Provider Business Practice Location Address
First Line : 10406 FLATLANDS AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11236-2806
Country : US
Telephone Number : 718-649-9930
Fax Number : 718-649-9931
Authorized Official
Title or Position : OWNER
Name : DR. PATRICIA MARIE MULLINGS
Credential : MD
Telephone Number : 718-649-9930
Provider Enumeration Date : 02/08/2007
Last Update Date : 08/22/2020

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Directions to “PMM MEDICAL PC ” Practice Location

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