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General NPI Number Information
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NPI Number | 1912860198
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Entity Type | Individual
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Provider Name | ZACKARY PAUL MULLEN
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Gender | Male
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Dates
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Enumeration Date | 12/04/2025
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 200 TILTON RD STE 5
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City | NORTHFIELD
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State | NJ
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Zip | 08225-1270
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Country | US
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Telephone | 609-400-3910
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Fax |
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Provider Business Mailing Address
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Address Line | 1023 COURTNEY WAY
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City | MOUNT LAUREL
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State | NJ
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Zip | 08054-6332
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207KA0200X
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Taxonomy Name | Allergy Physician
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License Number | 25MP00985500
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License Number State | NJ
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