Healthcare Provider Details

I. General information

NPI: 1487823613
Provider Name (Legal Business Name): JOSEPH J. MUELLER O.D.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2008
Last Update Date: 03/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

382 MAIN ST
SAUGERTIES NY
12477-1406
US

IV. Provider business mailing address

382 MAIN ST
SAUGERTIES NY
12477-1406
US

V. Phone/Fax

Practice location:
  • Phone: 845-246-2872
  • Fax: 845-246-7628
Mailing address:
  • Phone: 845-246-2872
  • Fax: 845-246-7628

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number3572
License Number StateNY

VIII. Authorized Official

Name: JOSEPH J MUELLER
Title or Position: SOLO PRACTICE
Credential: O.D.
Phone: 845-246-2872