Provider Demographics
NPI:1245291814
Name:MULLER-MCGOVERN, HOPE PATRICIA (OD)
Entity type:Individual
Prefix:
First Name:HOPE
Middle Name:PATRICIA
Last Name:MULLER-MCGOVERN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2238 31ST ST
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11105-2714
Mailing Address - Country:US
Mailing Address - Phone:718-278-3600
Mailing Address - Fax:718-278-3865
Practice Address - Street 1:2238 31ST ST
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11105-2714
Practice Address - Country:US
Practice Address - Phone:718-278-3600
Practice Address - Fax:718-278-3865
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2007-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV0057981152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYV11173Medicare UPIN
NY07935GMedicare PIN