Provider Demographics
NPI:1174719892
Name:RICHARD A MULLER MD
Entity type:Organization
Organization Name:RICHARD A MULLER MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:MULLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:315-232-4040
Mailing Address - Street 1:PO BOX 56
Mailing Address - Street 2:
Mailing Address - City:ADAMS
Mailing Address - State:NY
Mailing Address - Zip Code:13605-0056
Mailing Address - Country:US
Mailing Address - Phone:315-232-4040
Mailing Address - Fax:
Practice Address - Street 1:10480 US ROUTE 11
Practice Address - Street 2:
Practice Address - City:ADAMS
Practice Address - State:NY
Practice Address - Zip Code:13605-2118
Practice Address - Country:US
Practice Address - Phone:315-232-4040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-17
Last Update Date:2007-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY148723207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00705624Medicaid
NYAA0465Medicare PIN
NY00705624Medicaid