Provider Demographics
NPI:1922409507
Name:MULLEN, CARA (DO)
Entity Type:Individual
Prefix:
First Name:CARA
Middle Name:
Last Name:MULLEN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:CARA
Other - Middle Name:
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15 BANK ST
Mailing Address - Street 2:APT 112K
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10606-1917
Mailing Address - Country:US
Mailing Address - Phone:845-234-5510
Mailing Address - Fax:
Practice Address - Street 1:19 SPRING VALLEY MARKETPLACE
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10977-5210
Practice Address - Country:US
Practice Address - Phone:845-371-5437
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-15
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY286376-1208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics