Provider Demographics
NPI:1922080092
Name:MULHOLLAND, BRENDAN JOSEPH (MD)
Entity Type:Individual
Prefix:
First Name:BRENDAN
Middle Name:JOSEPH
Last Name:MULHOLLAND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 8519
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-8519
Mailing Address - Country:US
Mailing Address - Phone:732-460-9840
Mailing Address - Fax:732-460-9848
Practice Address - Street 1:35 S GILBERT ST
Practice Address - Street 2:
Practice Address - City:TINTON FALLS
Practice Address - State:NJ
Practice Address - Zip Code:07701-4954
Practice Address - Country:US
Practice Address - Phone:732-842-3050
Practice Address - Fax:732-530-0730
Is Sole Proprietor?:No
Enumeration Date:2005-11-15
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA6725800207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2283585OtherCIGNA HEALTHCARE OF NJ
NJ7773803Medicaid
NY07V471OtherEMPIRE BC BS OF NY
NJ0K9174OtherHEALTH NET OF NJ INC
080124994OtherMEDICARE RAILROAD
2031002OtherAETNA HEALTH HMO
NJ7773803Medicaid