Provider Demographics
NPI:1073954251
Name:MULLNER, CAREN ELIZABETH (OD)
Entity Type:Individual
Prefix:DR
First Name:CAREN
Middle Name:ELIZABETH
Last Name:MULLNER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:935 ROUTE 34
Mailing Address - Street 2:
Mailing Address - City:MATAWAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07747-3283
Mailing Address - Country:US
Mailing Address - Phone:732-583-9797
Mailing Address - Fax:732-583-3634
Practice Address - Street 1:935 ROUTE 34
Practice Address - Street 2:
Practice Address - City:MATAWAN
Practice Address - State:NJ
Practice Address - Zip Code:07747-3283
Practice Address - Country:US
Practice Address - Phone:732-583-9797
Practice Address - Fax:732-583-3634
Is Sole Proprietor?:No
Enumeration Date:2013-07-16
Last Update Date:2017-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00647900152W00000X
NJ27OM00114000152W00000X
NJ27OA00647901152W00000X
NJ27OA00647902152W00000X
NJ27OA00647903152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist