Provider Demographics
NPI:1417363979
Name:MULCAHEY, DANIELLE (LPN)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:MULCAHEY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 STATE ROUTE 104
Mailing Address - Street 2:SUITE 1
Mailing Address - City:OSWEGO
Mailing Address - State:NY
Mailing Address - Zip Code:13126-2956
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:300 STATE ROUTE 104
Practice Address - Street 2:SUITE 1
Practice Address - City:OSWEGO
Practice Address - State:NY
Practice Address - Zip Code:13126-2956
Practice Address - Country:US
Practice Address - Phone:315-342-0030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-05
Last Update Date:2014-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY316295-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse