Provider Demographics
NPI:1497097554
Name:MULAR, TERESA H (MD)
Entity Type:Individual
Prefix:DR
First Name:TERESA
Middle Name:H
Last Name:MULAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 2189
Mailing Address - Street 2:
Mailing Address - City:HALESITE
Mailing Address - State:NY
Mailing Address - Zip Code:11743-0808
Mailing Address - Country:US
Mailing Address - Phone:631-424-7661
Mailing Address - Fax:631-424-2813
Practice Address - Street 1:20 SYDNEY ROAD
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-1232
Practice Address - Country:US
Practice Address - Phone:631-424-7661
Practice Address - Fax:631-424-2813
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-26
Last Update Date:2013-03-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY130977207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA62205Medicare UPIN