Robert D. McMullen, MD, PC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

131895 Issued in NY

Legal business name

ROBERT D. MCMULLEN, MD, PC

Practice address

171 W 79TH St
Suite #2
New York, NY 10024-6449

Phone

(212) 362-9635

Fax

(212) 362-3997

NPI assigned

Jan 23, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Robert D. McMullen, MD

Title

President

Phone

(212) 362-9635

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1629123583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "171 W 79TH ST",
            "address_2": "SUITE #2",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100246449",
            "telephone_number": "212-362-9635",
            "fax_number": "212-362-3997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 W 79TH ST",
            "address_2": "SUITE #2",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100246449",
            "telephone_number": "212-362-9635",
            "fax_number": "212-362-3997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT D. MCMULLEN, MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCMULLEN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "212-362-9635",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NY",
            "license": "131895",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "131895",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in New York, NY
• Providers in New York, NY by specialty
• Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.