Provider Demographics
NPI:1023038106
Name:MULLIN, ANNE R (MD)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:R
Last Name:MULLIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 COATES DR
Mailing Address - Street 2:
Mailing Address - City:GOSHEN
Mailing Address - State:NY
Mailing Address - Zip Code:10924-6758
Mailing Address - Country:US
Mailing Address - Phone:845-651-1400
Mailing Address - Fax:845-651-1512
Practice Address - Street 1:3068 ROUTE 9W STE 200
Practice Address - Street 2:
Practice Address - City:NEW WINDSOR
Practice Address - State:NY
Practice Address - Zip Code:12553-7663
Practice Address - Country:US
Practice Address - Phone:845-534-9590
Practice Address - Fax:845-534-9685
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2019-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY179381207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
A400036997OtherMEDICARE
NY01375777Medicaid
NYF62229Medicare UPIN
NY18G172Medicare ID - Type Unspecified
NY01375777Medicaid