Provider Demographics
NPI:1447383799
Name:MULHALL-LOBEL, RITA ELLEN MULHALL (PT)
Entity Type:Individual
Prefix:
First Name:RITA ELLEN
Middle Name:MULHALL
Last Name:MULHALL-LOBEL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:RITA
Other - Middle Name:ELLEN
Other - Last Name:LOBEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:87 EDGEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:LARCHMONT
Mailing Address - State:NY
Mailing Address - Zip Code:10538-2205
Mailing Address - Country:US
Mailing Address - Phone:914-834-4775
Mailing Address - Fax:914-834-4777
Practice Address - Street 1:87 EDGEWOOD AVE
Practice Address - Street 2:
Practice Address - City:LARCHMONT
Practice Address - State:NY
Practice Address - Zip Code:10538-2205
Practice Address - Country:US
Practice Address - Phone:914-834-4775
Practice Address - Fax:914-834-4777
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005964-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQC1591Medicare ID - Type Unspecified