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NPI Code Detail

MEDICARE: CHRISTINA MULLADY

MEDICARE:   CHRISTINA  MULLADY
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
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1396195962
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINA MULLADY
Provider Business Mailing Address
First Line : 99 FRIENDSHIP DR
Second Line :
City : ROCKY POINT
State : NY
Zip : 11778-9656
Country : US
Telephone Number : 631-849-5378
Fax Number :
Provider Business Practice Location Address
First Line : 99 FRIENDSHIP DR
Second Line :
City : ROCKY POINT
State : NY
Zip : 11778-9656
Country : US
Telephone Number : 631-849-5378
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2016
Last Update Date : 06/15/2016

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Directions to “ CHRISTINA MULLADY ” Practice Location

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