Provider Demographics
NPI:1154658391
Name:MULHALL, JANET THERESA (LMT)
Entity Type:Individual
Prefix:MS
First Name:JANET
Middle Name:THERESA
Last Name:MULHALL
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:466 MORICHES RD
Mailing Address - Street 2:
Mailing Address - City:SAINT JAMES
Mailing Address - State:NY
Mailing Address - Zip Code:11780-2041
Mailing Address - Country:US
Mailing Address - Phone:631-584-2323
Mailing Address - Fax:631-584-0148
Practice Address - Street 1:466 MORICHES RD
Practice Address - Street 2:
Practice Address - City:SAINT JAMES
Practice Address - State:NY
Practice Address - Zip Code:11780-2041
Practice Address - Country:US
Practice Address - Phone:631-584-2323
Practice Address - Fax:631-584-0148
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-09
Last Update Date:2009-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003371-1225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist