Provider Demographics
NPI:1043665318
Name:MULLINGS, MARSHALEE
Entity Type:Individual
Prefix:
First Name:MARSHALEE
Middle Name:
Last Name:MULLINGS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 E 4TH ST
Mailing Address - Street 2:2C
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10550-4267
Mailing Address - Country:US
Mailing Address - Phone:914-920-1440
Mailing Address - Fax:
Practice Address - Street 1:70 E 4TH STREET
Practice Address - Street 2:2C
Practice Address - City:MOUNT VERNON
Practice Address - State:NY
Practice Address - Zip Code:10550
Practice Address - Country:US
Practice Address - Phone:914-920-1440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-25
Last Update Date:2016-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY702866-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse