NPIMap

Organization Active NPI

P.K. Mullick, MD & Associates PC

  • Psychiatry Physician
  • Pittsburgh, PA
National Provider Identifier
1699704890
Registry record updated Jul 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD030769E Issued in PA
Legal business name
P.K. MULLICK, MD & ASSOCIATES PC
Practice address
4608 Penn Ave
Pittsburgh, PA 15224-1309
Phone
(412) 621-4757
Fax
(412) 621-9784
NPI assigned
Jul 1, 2006
Last updated
Jul 15, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2008

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

Authorized official

Name
Dr. Prabir Kumar Mullick, MDNPI 1285603126
Title
President
Phone
(412) 621-4757

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X NU
Psychiatry Physician 2084P0800X MD030769E PA Primary

Addresses

Primary practice location

4608 Penn Ave
Pittsburgh, PA 15224-1309

Mailing address

4608 Penn Ave
Pittsburgh, PA 15224-1309
Phone (412) 621-4757

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050422000138 PA Part B Supplier - Clinic/Group Practice 4789622440 Receives reassigned benefits from 8 practitioners
Practice locations: Pittsburgh, PA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1151712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216080000000",
    "number": "1699704890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4608 PENN AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152241309",
            "telephone_number": "412-621-4757",
            "fax_number": "412-621-9784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4608 PENN AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152241309",
            "telephone_number": "412-621-4757",
            "fax_number": "412-621-9784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "P.K. MULLICK, MD & ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-01",
        "last_updated": "2008-07-15",
        "status": "A",
        "authorized_official_last_name": "MULLICK",
        "authorized_official_first_name": "PRABIR",
        "authorized_official_middle_name": "KUMAR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "412-621-4757",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD030769E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.