Provider Demographics
NPI:1396748281
Name:MULLEN, BARRY R (DPM)
Entity type:Individual
Prefix:DR
First Name:BARRY
Middle Name:R
Last Name:MULLEN
Suffix:
Gender:M
Credentials:DPM
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Mailing Address - Street 1:488 SCHOOLEYS MOUNTAIN RD
Mailing Address - Street 2:HASTINGS COMMONS 1B
Mailing Address - City:HACKETTSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07840-4001
Mailing Address - Country:US
Mailing Address - Phone:908-852-0229
Mailing Address - Fax:908-852-1076
Practice Address - Street 1:488 SCHOOLEYS MOUNTAIN RD
Practice Address - Street 2:HASTINGS COMMONS 1B
Practice Address - City:HACKETTSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07840-4001
Practice Address - Country:US
Practice Address - Phone:908-852-0229
Practice Address - Fax:908-852-1076
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MD00134700213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ512710DR9Medicare ID - Type Unspecified
NJT45640Medicare UPIN