Organization
KEVIN MULLINS MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN MULLINS MD (PRESIDENT)
(631) 422-5371
Entity
Organization
Contact information
Practice address
1175 MONTAUK HWY, SUITE 6, WEST ISLIP, NY 11795-4939
(631) 422-5371
Mailing address
1175 MONTAUK HWY, SUITE 6, WEST ISLIP, NY 11795-4939
(631) 422-5371
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
—
NY
207T00000X
Neurological Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DA9178
MEDICARE RR
NY
Enumeration date
01/05/2007
Last updated
10/16/2019
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