MEDICARE: MR. PETER E. MULBURY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Y00000X	Otolaryngology Physician	112245	NY

General Provider Information

NPI Number	:	1093718470
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. PETER E. MULBURY MD

Provider Business Mailing Address
First Line	:	360 LINDEN OAKS DRIVE
Second Line	:	SUITE 220
City	:	ROCHESTER
State	:	NY
Zip	:	14625
Country	:	US
Telephone Number	:	585-244-3510
Fax Number	:	585-244-3519

Provider Business Practice Location Address
First Line	:	360 LINDEN OAKS DRIVE
Second Line	:	SUITE 220
City	:	ROCHESTER
State	:	NY
Zip	:	14625
Country	:	US
Telephone Number	:	585-244-3510
Fax Number	:	585-244-3519

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/31/2005
Last Update Date	:	09/17/2015

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