Individual
MRS. BLAIRE MULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1500 ROUTE 112 STE 101, PORT JEFFERSON STATION, NY 11776-8054
(631) 751-3000
(631) 509-6559
Mailing address
5 MEDICAL DR, PORT JEFFERSON MEDICAL PARK, PORT JEFFERSON STATION, NY 11776-1601
(631) 678-8393
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
020067
NY
Other
Enumeration date
09/01/2016
Last updated
02/21/2019
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