Provider Demographics
NPI:1811168024
Name:MULCAHY, CONOR JOSEPH (DO)
Entity type:Individual
Prefix:
First Name:CONOR
Middle Name:JOSEPH
Last Name:MULCAHY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:100 N ACADEMY AVE # 4903
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-9800
Mailing Address - Country:US
Mailing Address - Phone:570-271-6144
Mailing Address - Fax:570-271-6578
Practice Address - Street 1:35 JUSTIN DRIVE
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:PA
Practice Address - Zip Code:17821-7951
Practice Address - Country:US
Practice Address - Phone:570-271-6164
Practice Address - Fax:570-271-6141
Is Sole Proprietor?:No
Enumeration Date:2008-03-14
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOS015316207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1025325780002Medicaid