Provider Demographics
NPI:1295002988
Name:MULLOKANDOV, ARTUR (DPT)
Entity Type:Individual
Prefix:DR
First Name:ARTUR
Middle Name:
Last Name:MULLOKANDOV
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4801 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07087-6516
Mailing Address - Country:US
Mailing Address - Phone:201-751-5000
Mailing Address - Fax:201-751-5010
Practice Address - Street 1:4801 BROADWAY
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:NJ
Practice Address - Zip Code:07087-6516
Practice Address - Country:US
Practice Address - Phone:201-751-5000
Practice Address - Fax:201-751-5010
Is Sole Proprietor?:No
Enumeration Date:2011-11-22
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY034486-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist