MEDICARE: DR. COLETTE COLLINS MULL M.D.

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
1	2080P0204X	Pediatric Emergency Medicine (Pediatrics) Physician	C10009889	DE
2	2080P0204X	Pediatric Emergency Medicine (Pediatrics) Physician	MD-059812-L	PA

Other Identifiers

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

General Provider Information

NPI Number	:	1588616544
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. COLETTE COLLINS MULL M.D.

Provider Business Mailing Address
First Line	:	1 HOLLOW LN, STE 301
Second Line	:
City	:	NEW HYDE PARK
State	:	NY
Zip	:	11042-1215
Country	:	US
Telephone Number	:	516-207-7851
Fax Number	:

Provider Business Practice Location Address
First Line	:	527 BALTIMORE PIKE
Second Line	:
City	:	SPRINGFIELD
State	:	PA
Zip	:	19064-3839
Country	:	US
Telephone Number	:	484-470-6767
Fax Number	:	484-470-6777

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/17/2006
Last Update Date	:	03/20/2026

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