Provider Demographics
NPI:1508235672
Name:MULLIN, ANTHONY (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:
Last Name:MULLIN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 E 26TH ST
Mailing Address - Street 2:APARTMENT 2
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-1927
Mailing Address - Country:US
Mailing Address - Phone:646-241-5309
Mailing Address - Fax:
Practice Address - Street 1:217 E 26TH ST
Practice Address - Street 2:APARTMENT 2
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-1927
Practice Address - Country:US
Practice Address - Phone:646-241-5309
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-18
Last Update Date:2021-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP99473103TC0700X
NY021971103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical