Individual
KEVIN MULLINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1175 MONTAUK HWY, STE 6, WEST ISLIP, NY 11795-4939
(833) 666-6066
(631) 337-7698
Mailing address
1175 MONTAUK HWY STE 6, WEST ISLIP, NY 11795-4939
(833) 666-6066
(631) 337-7698
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
1903771
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01924574
—
NY
01
—
P00077933
MEDICARE RR
NY
Enumeration date
01/25/2006
Last updated
09/28/2023
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