Healthcare Provider Details

I. General information

NPI: 1275918294
Provider Name (Legal Business Name): KAREN A MULHOLLAND PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2015
Last Update Date: 09/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 ROSA RD SUITE 382
SCHENECTADY NY
12308
US

IV. Provider business mailing address

124 ROSA RD SUITE 382
SCHENECTADY NY
12308
US

V. Phone/Fax

Practice location:
  • Phone: 518-386-3691
  • Fax: 518-386-3553
Mailing address:
  • Phone: 518-386-3691
  • Fax: 518-386-3553

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number021285
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: