Provider Demographics
NPI:1891966305
Name:MULLER, JEFF M (PHD)
Entity Type:Individual
Prefix:
First Name:JEFF
Middle Name:M
Last Name:MULLER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 COURT ST
Mailing Address - Street 2:SUITE 804
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-4421
Mailing Address - Country:US
Mailing Address - Phone:646-546-7159
Mailing Address - Fax:
Practice Address - Street 1:32 COURT ST
Practice Address - Street 2:SUITE 804
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-4421
Practice Address - Country:US
Practice Address - Phone:646-546-7159
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-13
Last Update Date:2013-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016165-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical