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General NPI Number Information
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NPI Number | 1063690543
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Entity Type | Organization
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Legal Business Name | JOHN MULAWKA DO PC
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Dates
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Enumeration Date | 02/06/2008
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Last Update Date | 04/23/2014
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Provider Practice Location Address
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Address Line | 194 CENTRAL AVENUE
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City | SILVER CREEK
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State | NY
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Zip | 14136-1338
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Country | US
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Telephone | 716-947-2222
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Fax | 716-947-2223
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Provider Business Mailing Address
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Address Line | 194 CENTRAL AVE
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City | SILVER CREEK
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State | NY
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Zip | 14136-1338
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Country | US
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Telephone | 716-947-2222
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Fax | 716-947-2223
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | JOHN MULAWKA III
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Credential | D.O.
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Telephone | 716-947-2222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 224453
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License Number State | NY
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