Provider Demographics
NPI:1295755098
Name:MULKAY, BEVERLY (RPH)
Entity type:Individual
Prefix:MS
First Name:BEVERLY
Middle Name:
Last Name:MULKAY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 KENILWORTH RD
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07450-4637
Mailing Address - Country:US
Mailing Address - Phone:201-445-5160
Mailing Address - Fax:
Practice Address - Street 1:6601 BROADWAY
Practice Address - Street 2:
Practice Address - City:WEST NEW YORK
Practice Address - State:NJ
Practice Address - Zip Code:07093-3249
Practice Address - Country:US
Practice Address - Phone:201-854-4900
Practice Address - Fax:201-854-4901
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI024900001835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy