Provider Demographics
NPI:1093802423
Name:MULLANEY AND ASSOCIATES PHYSICAL THERAPY
Entity Type:Organization
Organization Name:MULLANEY AND ASSOCIATES PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MULLANEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-576-1500
Mailing Address - Street 1:PO BOX 4071
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07748-4071
Mailing Address - Country:US
Mailing Address - Phone:732-576-1500
Mailing Address - Fax:732-576-1542
Practice Address - Street 1:127 MAIN ST
Practice Address - Street 2:SUITE E
Practice Address - City:MATAWAN
Practice Address - State:NJ
Practice Address - Zip Code:07747-2621
Practice Address - Country:US
Practice Address - Phone:732-970-4974
Practice Address - Fax:732-576-1542
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ098621Medicare ID - Type Unspecified