Provider Demographics
NPI:1154941862
Name:MULLEN, JEFFREY A
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:A
Last Name:MULLEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:773 ROUTE 70 E STE E100
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-2363
Mailing Address - Country:US
Mailing Address - Phone:856-942-3700
Mailing Address - Fax:856-452-5758
Practice Address - Street 1:773 ROUTE 70 E STE E100
Practice Address - Street 2:
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-2363
Practice Address - Country:US
Practice Address - Phone:856-942-3700
Practice Address - Fax:856-452-5758
Is Sole Proprietor?:No
Enumeration Date:2020-04-22
Last Update Date:2020-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist