Provider Demographics
NPI:1265567580
Name:MULLINS, MICHAEL L (MAPT)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:L
Last Name:MULLINS
Suffix:
Gender:M
Credentials:MAPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3843 BLOOMINGDALE DR
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NJ
Mailing Address - Zip Code:08844-5558
Mailing Address - Country:US
Mailing Address - Phone:908-359-2753
Mailing Address - Fax:
Practice Address - Street 1:30 MORRISTOWN RD
Practice Address - Street 2:
Practice Address - City:BERNARDSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07924-2316
Practice Address - Country:US
Practice Address - Phone:908-766-5663
Practice Address - Fax:908-766-7768
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00703500225100000X
NY0139451225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1321020OtherUNITED HEALTH CARE
NJ7754629OtherAETNA PPO
NJ3955073OtherAETNA POS
NJ4188707OtherCIGNA PPO
NJ7754629OtherAETNA PPO