John Mulawka DO, PC
Organization Active NPI Pediatrics Physician · Derby, NY
NPI 1831440932 · NPPES record last updated Sep 28, 2012
Key facts
- NPI
- 1831440932
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 224453 (NY)
- Legal business name
- JOHN MULAWKA DO, PC
- Practice address
- 6763 Erie Rd
Derby, NY 14047-9670 - Phone
- (716) 947-2222
- Fax
- (716) 947-2223
- NPI assigned
- Sep 28, 2012
- Organization subpart
- No
Authorized official
- Name
- John Michael Mulawka III, DO
- Title
- Owner
- Phone
- (716) 947-2222
Corporate family (same tax ID) 1
Practitioners 10
-
Sandra Chandia, FNP
-
Gabriella Clare, FNP-BC
-
Johnna Coleman, FNP
-
Samantha Jenkins, RPA
-
Devon Marie Migaj, FNP-C
-
Jacqueline Ann Sikinoff, PA-C
-
Betsy L Strack, P.A.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 33D1049131 | John Mulawka DO PC | Certificate of waiver | Dec 22, 2027 |
National Provider Directory
- Tax ID family
- John Mulawka DO PC
Locations
6763 Erie Rd
Derby, NY 14047
Phone (716) 947-2222
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician |
208000000X | 224453 | NY | Yes |
Addresses
Primary practice location
6763 Erie Rd
Derby, NY 14047-9670
Mailing address
6763 Erie Rd
Derby, NY 14047-9670
Phone (716) 947-2222
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01887952 | Medicaid | NY |
Other providers in Derby, NY
- James G Harrity
- Rebecca Louise Healy
- Linda A. Hegyi
- Crystal Hrubiak
- J. Sills, Speech-Language Pathology, PLLC
- Julie Kuster
- Lakeshore Chiropractic Wellness PLLC
- Lakeshore Family Medicine Assoc PC
- Lakeshore Family Medicine Associates PC
- Debra Sue Longbine
All providers in Derby, NY · Pediatrics Physician in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 28, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.