Provider Demographics
NPI:1700199437
Name:MULBERGER, DEBORAH ELAINE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:ELAINE
Last Name:MULBERGER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5755 MORAN RD
Mailing Address - Street 2:
Mailing Address - City:CANANDAIGUA
Mailing Address - State:NY
Mailing Address - Zip Code:14424-9013
Mailing Address - Country:US
Mailing Address - Phone:585-394-5864
Mailing Address - Fax:
Practice Address - Street 1:5755 MORAN RD
Practice Address - Street 2:
Practice Address - City:CANANDAIGUA
Practice Address - State:NY
Practice Address - Zip Code:14424-9013
Practice Address - Country:US
Practice Address - Phone:585-394-5864
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-22
Last Update Date:2010-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0871351164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse