Individual
GREGORY MULLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1290 UPPER FRONT ST, BINGHAMTON, NY 13901-1043
(607) 722-3417
(607) 722-7610
Mailing address
346 GRAND AVE, JOHNSON CITY, NY 13790-2558
(607) 770-0025
(607) 729-3982
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
202521
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01657258
—
NY
Enumeration date
08/23/2005
Last updated
11/19/2011
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