MEDICARE: LAUREN E MULVEY

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	363A00000X	Physician Assistant	032151	NY

General Provider Information

NPI Number	:	1770315269
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN E MULVEY

Provider Business Mailing Address
First Line	:	208 CRITTENDEN WAY APT 5
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14623-2241
Country	:	US
Telephone Number	:	585-943-5259
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 SOUTH DR
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14612-1138
Country	:	US
Telephone Number	:	585-473-2200
Fax Number	:

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

Provider Enumeration Date	:	08/14/2024
Last Update Date	:	12/30/2025

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Directions to “ LAUREN E MULVEY ” Practice Location

Language	Start Address	Practice Location

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