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General NPI Number Information
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NPI Number | 1871917427
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Entity Type | Organization
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Legal Business Name | WILLIAM A MULLANE PSYCHOLOGIST PC
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Dates
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Enumeration Date | 02/18/2014
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Last Update Date | 02/18/2014
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Provider Practice Location Address
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Address Line | 30 WEST 60TH STREET 1R
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City | NEW YORK
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State | NY
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Zip | 10023
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Country | US
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Telephone | 347-709-8496
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Fax | 718-645-1148
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Provider Business Mailing Address
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Address Line | 29 W. DEVONIA AVENUE
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City | MOUNT VERNON
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State | NY
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Zip | 10552
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Country | US
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Telephone | 516-769-5965
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Fax | 718-645-1148
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Authorized Official
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Title or Position | CEO
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Name | WILLIAM MULLANE
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Credential | PH.D
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Telephone | 718-645-1118
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 020028
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License Number State | NY
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