Provider Demographics
NPI:1194564872
Name:MULATU, BINIYAM SIMENEH (MD)
Entity type:Individual
Prefix:DR
First Name:BINIYAM
Middle Name:SIMENEH
Last Name:MULATU
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:703 ROGERS AVE
Mailing Address - Street 2:APT2C
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226
Mailing Address - Country:US
Mailing Address - Phone:215-433-2191
Mailing Address - Fax:
Practice Address - Street 1:703 ROGERS AVE
Practice Address - Street 2:APT2C
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226
Practice Address - Country:US
Practice Address - Phone:215-433-2191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-22
Last Update Date:2025-03-06
Deactivation Date:2025-01-14
Deactivation Code:
Reactivation Date:2025-03-06
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program