Provider Demographics
NPI:1326863721
Name:ELIZABETH W MULWA
Entity type:Organization
Organization Name:ELIZABETH W MULWA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:MULWA
Authorized Official - Middle Name:
Authorized Official - Last Name:ELIZABETH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-590-5423
Mailing Address - Street 1:306 LELAND PL
Mailing Address - Street 2:
Mailing Address - City:HILLSIDE
Mailing Address - State:NJ
Mailing Address - Zip Code:07205-2718
Mailing Address - Country:US
Mailing Address - Phone:908-590-5423
Mailing Address - Fax:908-365-0468
Practice Address - Street 1:20 COMMERCE DR STE 135
Practice Address - Street 2:
Practice Address - City:CRANFORD
Practice Address - State:NJ
Practice Address - Zip Code:07016-3614
Practice Address - Country:US
Practice Address - Phone:908-590-5423
Practice Address - Fax:908-365-0468
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-20
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty