Provider Demographics
NPI:1003067927
Name:MULRYAN, JOSEPH V (AUDIOLOGIST)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:V
Last Name:MULRYAN
Suffix:
Gender:M
Credentials:AUDIOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 COLLINS AVE
Mailing Address - Street 2:
Mailing Address - City:KINGS PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11754-2601
Mailing Address - Country:US
Mailing Address - Phone:718-938-4297
Mailing Address - Fax:
Practice Address - Street 1:7506 ELIOT AVE
Practice Address - Street 2:
Practice Address - City:MIDDLE VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11379-1207
Practice Address - Country:US
Practice Address - Phone:718-335-2224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-09
Last Update Date:2011-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001395231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist