Provider Demographics
NPI:1659496792
Name:LAURIE MULVEY, MD L.L.C
Entity Type:Organization
Organization Name:LAURIE MULVEY, MD L.L.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:WILNO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-895-9700
Mailing Address - Street 1:213 NASSAU ST
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08542-4601
Mailing Address - Country:US
Mailing Address - Phone:609-924-1661
Mailing Address - Fax:609-924-8728
Practice Address - Street 1:213 NASSAU ST
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08542-4601
Practice Address - Country:US
Practice Address - Phone:609-924-1661
Practice Address - Fax:609-924-8728
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA03996900207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MES286OtherOXFORD ID
12878OtherAETNA ID
0562355000OtherAMERIHEALTH ID