Individual
DR. EDWARD E MULLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 HEALTHY WAY, OCEANSIDE, NY 11572-1551
(516) 632-3303
(516) 336-2930
Mailing address
PO BOX 5670, HICKSVILLE, NY 11802-5670
(516) 632-3370
(516) 336-2930
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
172604
NY
2085R0001X
Radiation Oncology Physician
Primary
172604-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01465513
—
NY
05
—
1466513
—
NY
Enumeration date
07/08/2005
Last updated
02/14/2017
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