Provider Demographics
NPI:1356480701
Name:MULLANEY, MAUREEN PATRICIA (MS EDSPED)
Entity Type:Individual
Prefix:MISS
First Name:MAUREEN
Middle Name:PATRICIA
Last Name:MULLANEY
Suffix:
Gender:F
Credentials:MS EDSPED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12058 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:COLLEGE POINT
Mailing Address - State:NY
Mailing Address - Zip Code:11356-1102
Mailing Address - Country:US
Mailing Address - Phone:347-732-4048
Mailing Address - Fax:
Practice Address - Street 1:12058 5TH AVE
Practice Address - Street 2:
Practice Address - City:COLLEGE POINT
Practice Address - State:NY
Practice Address - Zip Code:11356-1102
Practice Address - Country:US
Practice Address - Phone:347-732-4048
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2007-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services