Provider Demographics
NPI:1194839274
Name:MULLIN, CHRISTOPHER J (DPM)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:J
Last Name:MULLIN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 CAMBRIDGE DR
Mailing Address - Street 2:SUITE D
Mailing Address - City:ABERDEEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07747-2256
Mailing Address - Country:US
Mailing Address - Phone:732-566-2841
Mailing Address - Fax:732-566-1264
Practice Address - Street 1:20 CAMBRIDGE DR
Practice Address - Street 2:SUITE D
Practice Address - City:ABERDEEN
Practice Address - State:NJ
Practice Address - Zip Code:07747-2256
Practice Address - Country:US
Practice Address - Phone:732-566-2841
Practice Address - Fax:732-566-1264
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2011-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00253600213ES0131X
NYN005455213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ01912631Medicaid
NJ01912631Medicaid
U71043Medicare UPIN
NJ052116TC0Medicare PIN