Provider Demographics
NPI:1538329420
Name:MCMULLEN, PATRICIA M (NP)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:M
Last Name:MCMULLEN
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:1 GUSTAVE L LEVY PL # 1033
Mailing Address - Street 2:5 EAST 98TH STREET, 3RD FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-6500
Mailing Address - Country:US
Mailing Address - Phone:212-241-0740
Mailing Address - Fax:212-241-5107
Practice Address - Street 1:1 GUSTAVE L LEVY PL # 1033
Practice Address - Street 2:5 EAST 98TH STREET, 3RD FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6500
Practice Address - Country:US
Practice Address - Phone:212-241-0740
Practice Address - Fax:212-241-5107
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-13
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYF3012971363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYS85303Medicare UPIN