Provider Demographics
NPI:1225188477
Name:MULAY, SWATI S
Entity Type:Individual
Prefix:
First Name:SWATI
Middle Name:S
Last Name:MULAY
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 1:1320 NORCROSS CT
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40513-1921
Mailing Address - Country:US
Mailing Address - Phone:859-219-0850
Mailing Address - Fax:
Practice Address - Street 1:110 ROACH ST
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:KY
Practice Address - Zip Code:40324-9393
Practice Address - Country:US
Practice Address - Phone:859-253-1686
Practice Address - Fax:859-254-2743
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2011-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY298512084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY30615058Medicaid
KY0331306Medicare ID - Type UnspecifiedMEDICARE
KY0045351Medicare ID - Type UnspecifiedMEDICARE
KY0331005Medicare ID - Type UnspecifiedMEDICARE
KY260035536Medicare ID - Type UnspecifiedMEDICARE
KY3310Medicare ID - Type UnspecifiedMEDICARE
KYF69520Medicare UPIN
KY0331408Medicare ID - Type UnspecifiedMEDICARE
KY0332004Medicare ID - Type UnspecifiedMEDICARE
KY0331117Medicare ID - Type UnspecifiedMEDICARE
KY30615058Medicaid