Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | 25MD00253600 | NJ |
N | 213ES0131X | Foot Surgery | N005455 | NY |
NPI | 1194839274 |
---|---|
Provider Name | Christopher J Mullin |
First Address | Aberdeen, NJ 07747-2256 |
Second Address | Aberdeen, NJ 07747-2256 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2006 |
Last Update Date | 03/02/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01912631 | (05) | NJ |
U71043 | (02) |