MICHAEL THOMAS MULLEN JR. (NPI# 1306901533) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306901533 |
| Entity Type | Individual |
| Full Name | MICHAEL THOMAS MULLEN JR. |
| Credential | MD |
| Practice Address |
3400 Civic Center Blvd 2nd Floor South Pavillion Philadelphia PA 19104-5127 |
| Practice Telephone | 2156623606 |
| Practice Fax Number | 2153495579 |
| Mailing Telephone | 2156623606 |
| Mailing Fax Number | 2153495579 |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2015-06-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
MD437409 | PA | Allopathic & Osteopathic Physicians |
| Y | 2084V0102X |
Psychiatry & Neurology Specialization: Vascular Neurology |
MD437409 | PA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861026544 | Michael Mullen | Social Worker | 4335 San Pedro Dr Ne Apt E7, Albuquerque, NM 87109-2682 | 2020-03-02 |
| 1174029078 | Michael Bryan Mullen | Otolaryngology | 358 Duke Rd, Lexington, KY 40502 | 2018-04-01 |
| 1790073070 | Michael James Mullen | Pharmacist | 2200 Westchester Dr, St 126, High Point, NC 27262-7099 | 2011-07-20 |
| 1790815462 | Michael Romney Mullen | Dentist | 2039 Trawood, El Paso, TX 79935 | 2007-03-06 |
| 1962550384 | Michael Joseph Mullen IIi | Dentist | 943 West Countyline Road, Warmmister Township, Hatboro P O, PA 19040-1008 | 2007-01-08 |
| 1942282694 | Michael Lewis Mullen | Chiropractor | 304 Grant Rd, Suite 1, East Wenatchee, WA 98802-5384 | 2005-11-17 |
| 1316390917 | Michael Campbell Mullen | Hearing Instrument Specialist | 406 Blankenbaker Pkwy, Middletown, KY 40243-1881 | 2016-07-19 |
| 1417356825 | Michael Edward Mullen | Physician Assistant | 856 Century Drive, Mechanicsburg, PA 17055-4505 | 2014-08-21 |
| 1215203195 | Michael Peter Mullen | Physician Assistant | 36000 Darnall Loop, Carl R. Darnall Army Medical Center, Fort Hood, TX 76544 | 2012-03-26 |
| 1629269758 | Michael G Mullen | Counselor | 5 W Cayuga St, Oswego, NY 13126-2031 | 2007-08-05 |
| Street Address |
3400 CIVIC CENTER BLVD 2ND FLOOR SOUTH PAVILLION |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19104-5127 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124027727 | Joel D Glickman | Internal Medicine | 3400 Civic Center Blvd, 1st Floor, Suite 300 S, Philadelphia, PA 19104-4306 | 2005-07-18 |
| 1841891058 | Abigail Brooke Horowitz | Nurse Practitioner | 3400 Civic Center Blvd, Philadelphia, PA 19104-5127 | 2020-11-04 |
| 1073129532 | Samuel Kovell | Physician Assistant | 3400 Civic Center Blvd, Philadelphia, PA 19104-5127 | 2020-09-21 |
| 1306451695 | Farzad Nourollah-zadeh | Oral Medicinist | 3400 Civic Center Blvd, Philadelphia, PA 19104-5127 | 2020-09-13 |
| 1609492917 | Mosetta Harris | Nurse Practitioner | 3400 Civic Center Blvd, Philadelphia, PA 19104-5127 | 2020-06-23 |
| 1063032530 | Monique Maria Tee | Internal Medicine | 3400 Civic Center Blvd, Philadelphia, PA 19104-5127 | 2020-04-24 |
| 1609495290 | Katharine Freeman Michel | Student in an Organized Health Care Education/Training Program | 3400 Civic Center Blvd, 3rd Floor West Pavilion, Philadelphia, PA 19104 | 2020-04-13 |
| 1609495498 | Taha Samir Ghouleh | Student in an Organized Health Care Education/Training Program | 3400 Civic Center Blvd, Philadelphia, PA 19104-5127 | 2020-04-11 |
| 1952930554 | Danielle Marie Lamarra | Nurse Practitioner | 3400 Civic Center Blvd, Philadelphia, PA 19104-5127 | 2020-04-06 |
| 1982232658 | Jasmine Hwang | Student in an Organized Health Care Education/Training Program | 3400 Civic Center Blvd, Philadelphia, PA 19104-5127 | 2020-03-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639770829 | Michelle Morris | Student in an Organized Health Care Education/Training Program | Dept. of Family Medicine & Community Health, 3737 Market, Philadelphia, PA 19104 | 2020-11-04 |
| 1346853041 | Spectrum Health Services, Inc. | Clinic/Center | 1415 South University Ave, Philadelphia, PA 19104 | 2020-08-24 |
| 1770104259 | Fatimah Sorefan-mangou | Student in an Organized Health Care Education/Training Program | 4 Maloney 3400 Spruce Street, Philadelphia, PA 19104 | 2020-05-06 |
| 1114548690 | Rebecca Blaguski | Registered Nurse | The Hospital of The University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104 | 2020-05-06 |
| 1952944175 | Rebecca Miriam Barmherzig | Psychiatry & Neurology | 3501 Civic Centre Blvd, 10th Flr Ctrb, Neurology, Philadelphia, PA 19104 | 2019-10-21 |
| 1891257101 | James Paul Byrne | Surgery | Penn Presbyterian Medical Center, Division of Trauma, S, 51 N. 39th Street, Suite 120, 1st Floor Medical Office, Philadelphia, PA 19104 | 2019-04-04 |
| 1093276453 | Lauren Shreve | Student in an Organized Health Care Education/Training Program | Department of Surgery, Surgery Education - Penn Health, 3400 Spruce Street, 4 Maloney, Philadelphia, PA 19104 | 2019-03-28 |
| 1285194282 | Lauren M Christie | Student in an Organized Health Care Education/Training Program | Penn Presbyterian Medical Center, 51 N. 39th Street, Philadelphia, PA 19104 | 2019-03-25 |
| 1114487683 | Sabrina Layne | Student in an Organized Health Care Education/Training Program | 3400 Spruce Street, 100 Centrex, Philadelphia, PA 19104 | 2019-03-21 |
| 1811457310 | Kia Lor | Student in an Organized Health Care Education/Training Program | Hospital of University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19104 | 2019-03-21 |
| Find all providers in zip 19104 | ||||
| Taxonomy Code | 2084V0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Vascular Neurology |
| Vascular Neurology is a subspecialty in the evaluation, prevention, treatment and recovery from vascular diseases of the nervous system. This subspecialty includes the diagnosis and treatment of vascular events of arterial or venous origin from a large number of causes that affect the brain or spinal cord such as ischemic stroke, intracranial hemorrhage, spinal cord ischemia and spinal cord hemorrhage. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073879615 | Paul Joseph Novello | Psychiatry & Neurology | 3400 Spruce St, Philadelphia, PA 19104-4238 | 2012-04-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336699859 | Vaibhav Goswami | Psychiatry & Neurology | 301 S 7th Ave Ste 3020, West Reading, PA 19611-1494 | 2016-10-07 |
| 1255742227 | Danoushka Tememe | Psychiatry & Neurology | 120 East Second St., 3rd Floor, Erie, PA 16507 | 2014-05-13 |
| 1184175804 | Tower Health Medical Group | Psychiatry & Neurology | 420 S 5th Ave, West Reading, PA 19611-2143 | 2016-10-18 |
| 1013335330 | Kunakorn Atchaneeyasakul | Psychiatry & Neurology | 200 Lothrop St, Pittsburgh, PA 15213-2536 | 2014-04-03 |
| 1376983767 | Nitya Bandla Mambalam | Psychiatry & Neurology | 1417 8th Ave, Bethlehem, PA 18018-2256 | 2013-06-28 |
| 1255674248 | Glenn Leonel Konsky | Psychiatry & Neurology | 1417 8th Ave, Bethlehem, PA 18018 | 2013-03-28 |
| 1093790677 | Ashis H Tayal | Psychiatry & Neurology | 420 E North Ave Ste 206, Pittsburgh, PA 15212-4746 | 2005-12-07 |
| City | PHILADELPHIA |
| Zip Code | 19104 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.