Provider Demographics
NPI:1972872174
Name:MULLEN, THOMAS E (PHD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:E
Last Name:MULLEN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:65 LANDSDOWNE ST
Mailing Address - Street 2:LABORATORY FOR MOLECULAR MEDICINE
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02139-4232
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:65 LANDSDOWNE ST
Practice Address - Street 2:LABORATORY FOR MOLECULAR MEDICINE
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02139-4232
Practice Address - Country:US
Practice Address - Phone:617-768-8324
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-19
Last Update Date:2011-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2011132207SG0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207SG0203XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Molecular Genetics