Provider Demographics
NPI:1245364314
Name:MULLICK, BHARATI (MD)
Entity type:Individual
Prefix:DR
First Name:BHARATI
Middle Name:
Last Name:MULLICK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:295 BALTUSROL WAY
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07081-2108
Mailing Address - Country:US
Mailing Address - Phone:973-467-2644
Mailing Address - Fax:973-954-2347
Practice Address - Street 1:295 BALTUSROL WAY
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07081-2108
Practice Address - Country:US
Practice Address - Phone:973-467-2644
Practice Address - Fax:973-954-2347
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ29330208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics