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General NPI Number Information
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NPI Number | 1699704890
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Entity Type | Organization
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Legal Business Name | P.K. MULLICK, MD & ASSOCIATES PC
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Dates
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Enumeration Date | 07/01/2006
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Last Update Date | 07/15/2008
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Provider Practice Location Address
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Address Line | 4608 PENN AVE
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City | PITTSBURGH
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State | PA
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Zip | 15224-1309
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Country | US
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Telephone | 412-621-4757
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Fax | 412-621-9784
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Provider Business Mailing Address
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Address Line | 4608 PENN AVE
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City | PITTSBURGH
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State | PA
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Zip | 15224-1309
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Country | US
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Telephone | 412-621-4757
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Fax | 412-621-9784
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PRABIR KUMAR MULLICK
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Credential | MD
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Telephone | 412-621-4757
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD030769E
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License Number State | PA
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