1922080092 NPI number — BRENDAN JOSEPH MULHOLLAND MD

Table of content: LABRENDA ELAINA ARRINGTON (NPI 1770478935)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922080092 NPI number — BRENDAN JOSEPH MULHOLLAND MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MULHOLLAND
Provider First Name:
BRENDAN
Provider Middle Name:
JOSEPH
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1922080092
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/15/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 8519
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RED BANK
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07701-8519
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
732-460-9840
Provider Business Mailing Address Fax Number:
732-460-9848

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
35 S GILBERT ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TINTON FALLS
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07701-4954
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
732-842-3050
Provider Business Practice Location Address Fax Number:
732-530-0730
Provider Enumeration Date:
11/15/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  25MA6725800 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2283585 . This is a "CIGNA HEALTHCARE OF NJ" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 7773803 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 07V471 . This is a "EMPIRE BC BS OF NY" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 0K9174 . This is a "HEALTH NET OF NJ INC" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 080124994 . This is a "MEDICARE RAILROAD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2031002 . This is a "AETNA HEALTH HMO" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com