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Individual

GREGORY MUKALIAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
1113 HOSPITAL DR STE 100A, WILLINGBORO, NJ 08046-1128
(609) 835-5821
(609) 835-5827
Mailing address
301 LIPPINCOTT DR STE 410, MARLTON, NJ 08053-4197
(856) 355-0340
(856) 355-0330

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
25MB06369000
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7031904
NJ
Enumeration date
08/09/2005
Last updated
10/21/2024
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