Individual
ELAINE MULLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., OTR
Contact information
Practice address
513 W 166TH ST FL 4, NEW YORK, NY 10032-4207
(212) 928-8300
Mailing address
513 W 166TH ST FL 4, NEW YORK, NY 10032-4207
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
003823
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003823
LICENSE
NY
Enumeration date
09/23/2013
Last updated
09/23/2013
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