Individual
DR. MICHAEL J MULVANEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
264 WASHINGTON AVENUE EXT STE 201, ALBANY, NY 12203
(518) 452-1928
(518) 362-1348
Mailing address
264 WASHINGTON AVENUE EXT STE 201, ALBANY, NY 12203-6352
(518) 452-1928
(518) 362-1348
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
207ND0101X
MOHS-Micrographic Surgery Physician
182393
NY
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
182393-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1823931
NYLICENSE
NY
Enumeration date
08/25/2005
Last updated
06/15/2022
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