Provider Demographics
NPI:1043070808
Name:MINDFUL NEUROLOGY, PLLC
Entity Type:Organization
Organization Name:MINDFUL NEUROLOGY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN / OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:MULUKUTLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-884-2442
Mailing Address - Street 1:PO BOX 426
Mailing Address - Street 2:
Mailing Address - City:HARRIMAN
Mailing Address - State:NY
Mailing Address - Zip Code:10926-0426
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:917-477-6456
Practice Address - Street 1:66 SAPPHIRE RD
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NY
Practice Address - Zip Code:10950-5539
Practice Address - Country:US
Practice Address - Phone:516-884-2442
Practice Address - Fax:917-477-6456
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-20
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy