Provider Demographics
NPI:1508441510
Name:MULLEN, CHERIE A
Entity Type:Individual
Prefix:
First Name:CHERIE
Middle Name:A
Last Name:MULLEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 COUNTY ROUTE 51A
Mailing Address - Street 2:
Mailing Address - City:OSWEGO
Mailing Address - State:NY
Mailing Address - Zip Code:13126-5825
Mailing Address - Country:US
Mailing Address - Phone:315-529-8588
Mailing Address - Fax:
Practice Address - Street 1:56 HIGHMORE DR
Practice Address - Street 2:
Practice Address - City:OSWEGO
Practice Address - State:NY
Practice Address - Zip Code:13126-5646
Practice Address - Country:US
Practice Address - Phone:315-402-6479
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-11
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health