Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | 085497 | NY |
NPI | 1033171418 |
---|---|
Provider Name | June Mulvaney |
First Address | Brooklyn, NY 11216-2607 |
Second Address | Brooklyn, NY 11216-2607 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2006 |
Last Update Date | 08/07/2007 |