Provider Demographics
NPI:1508602517
Name:MULLAHEY, COLE WILLIAM
Entity type:Individual
Prefix:MR
First Name:COLE
Middle Name:WILLIAM
Last Name:MULLAHEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 ROCKAWAY AVE
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-4307
Mailing Address - Country:US
Mailing Address - Phone:516-512-1707
Mailing Address - Fax:
Practice Address - Street 1:1 ROCKAWAY AVE
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-4307
Practice Address - Country:US
Practice Address - Phone:516-512-1707
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-08
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician