Michael Mulligan

Individual provider Active NPI Registered Nurse · Piermont, NY

NPI 1619862885 · NPPES record last updated Jun 10, 2025

Key facts

NPI
1619862885
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
758464 (NY)
Practice address
8 E Lawrence Park Dr
Piermont, NY 10968-3135
Phone
(845) 825-7459
NPI assigned
Jun 10, 2025
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
758464NYMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 758464 NY Yes

Addresses

Primary practice location

8 E Lawrence Park Dr
Piermont, NY 10968-3135

Mailing address

8 E Lawrence Park Dr
Piermont, NY 10968-3135

Other providers in Piermont, NY

All providers in Piermont, NY · Registered Nurse in New York

Sources for this page

Verify at the official NPI Registry.