Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0402X | Child Neurologist | 2481291 | NY |
NPI | 1306851951 |
---|---|
Provider Name | Mrs. Jennifer Lynn Mulbury |
First Address | Rochester, NY 14621-3008 |
Second Address | Rochester, NY 14621-3008 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/07/2006 |
Last Update Date | 12/08/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03275147 | (05) | NY |