Provider Demographics
NPI:1821350547
Name:MULLANEY, AMANDA BRIDGET (MS ED)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:BRIDGET
Last Name:MULLANEY
Suffix:
Gender:F
Credentials:MS ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8000 4TH AVE APT 122
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-3945
Mailing Address - Country:US
Mailing Address - Phone:718-581-7775
Mailing Address - Fax:
Practice Address - Street 1:7616 13TH AVE
Practice Address - Street 2:THURSDAY'S CHILD
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11228-2412
Practice Address - Country:US
Practice Address - Phone:718-630-5100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-08
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist