Provider Demographics
NPI:1275918294
Name:MULHOLLAND, KAREN A (PA-C)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:A
Last Name:MULHOLLAND
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 ROSA RD
Mailing Address - Street 2:SUITE 382
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12308
Mailing Address - Country:US
Mailing Address - Phone:518-386-3691
Mailing Address - Fax:518-386-3553
Practice Address - Street 1:124 ROSA RD
Practice Address - Street 2:SUITE 382
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12308
Practice Address - Country:US
Practice Address - Phone:518-386-3691
Practice Address - Fax:518-386-3553
Is Sole Proprietor?:No
Enumeration Date:2015-07-21
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363AM0700X
NY021285363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04925297Medicaid