Active NPI
Andrew E Mulberg, M.D.
- Pediatrics Physician
- Camden, NJ
National Provider Identifier
1184630808
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- MD039755E
- Practice address
- 3 Cooper PLZ
Camden, NJ 08103-1438 - Phone
- (856) 751-9339
- NPI assigned
- Aug 1, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MD039755E | PA | Primary |
| Pediatric Emergency Medicine (Pediatrics) Physician | 2080P0204X | MD039755E | PA | |
| Pediatric Gastroenterology Physician | 2080P0206X | MD039755E | PA |
Addresses
Primary practice location
3 Cooper PLZ
Camden, NJ 08103-1438
Mailing address
3 Cooper PLZ
Camden, NJ 08103-1438
Phone (856) 751-9339
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6039707 | Medicaid | NJ | |
| 001436126 | Medicaid | PA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD039755E | PA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1422403200000",
"number": "1184630808",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3 COOPER PLZ",
"city": "CAMDEN",
"state": "NJ",
"postal_code": "081031438",
"telephone_number": "856-751-9339"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3 COOPER PLZ",
"city": "CAMDEN",
"state": "NJ",
"postal_code": "081031438",
"telephone_number": "856-751-9339"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MULBERG",
"first_name": "ANDREW",
"middle_name": "E",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-01",
"last_updated": "2015-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "PA",
"license": "MD039755E",
"primary": true
},
{
"code": "2080P0204X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Emergency Medicine",
"state": "PA",
"license": "MD039755E",
"primary": false
},
{
"code": "2080P0206X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Gastroenterology",
"state": "PA",
"license": "MD039755E",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6039707",
"state": "NJ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001436126",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Camden, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.