Provider Demographics
NPI:1568723567
Name:MULE, DINA MARIE (M SED)
Entity Type:Individual
Prefix:MS
First Name:DINA
Middle Name:MARIE
Last Name:MULE
Suffix:
Gender:F
Credentials:M SED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2213 E TREMONT AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10462-6301
Mailing Address - Country:US
Mailing Address - Phone:718-683-3775
Mailing Address - Fax:
Practice Address - Street 1:2847 PHILIP AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10465-2214
Practice Address - Country:US
Practice Address - Phone:718-863-0386
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-06
Last Update Date:2012-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY149986021174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist