Individual provider Active NPI

Kristin Constance Mullen, PTA

  • Physical Therapy Assistant
  • West Nyack, NY
National Provider Identifier
1265342844
Registry record updated Sep 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
008689 Issued in NY
Practice address
65 Parrott Rd
West Nyack, NY 10994-1025
Phone
(845) 627-4700
NPI assigned
Sep 8, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 225200000X 008689 NY Primary

Addresses

Primary practice location

65 Parrott Rd
West Nyack, NY 10994-1025

Mailing address

33 Grand St
Warwick, NY 10990-1036
Phone (845) 492-9178

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)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1788825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788825600000",
    "number": "1265342844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 GRAND ST",
            "city": "WARWICK",
            "state": "NY",
            "postal_code": "109901036",
            "telephone_number": "845-492-9178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 PARROTT RD",
            "city": "WEST NYACK",
            "state": "NY",
            "postal_code": "109941025",
            "telephone_number": "845-627-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLEN",
        "first_name": "KRISTIN",
        "middle_name": "CONSTANCE",
        "name_prefix": "Ms.",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-09-08",
        "last_updated": "2026-09-08",
        "certification_date": "2026-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapy Assistant",
            "state": "NY",
            "license": "008689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Nyack, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.