Active NPI
Justin Mullen
- Student in an Organized Health Care Education/Training Program
- Newark, NJ
National Provider Identifier
1801359401
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 110 Bergen St
Newark, NJ 07103-2495 - Phone
- (201) 742-2802
- NPI assigned
- Apr 10, 2019
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
110 Bergen St
Newark, NJ 07103-2495
Mailing address
45 Pine PL
Harrington Park, NJ 07640-1109
Phone (201) 742-2802
Other practice location 1
30 Prospect Ave
Hackensack, NJ 07601-1915
Phone (201) 742-2802
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": "1554854400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1554854400000",
"number": "1801359401",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "45 PINE PL",
"city": "HARRINGTON PARK",
"state": "NJ",
"postal_code": "076401109",
"telephone_number": "201-742-2802"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 BERGEN ST",
"city": "NEWARK",
"state": "NJ",
"postal_code": "071032495",
"telephone_number": "201-742-2802"
}
],
"practiceLocations": [
{
"address_1": "30 Prospect Ave",
"address_purpose": "LOCATION",
"city": "Hackensack",
"state": "NJ",
"postal_code": "076011915",
"country_code": "US",
"telephone_number": "201-742-2802",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MULLEN",
"first_name": "JUSTIN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-04-10",
"last_updated": "2019-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newark, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.