Provider Demographics
NPI:1538255336
Name:ROBERT J MULCARE MD PC
Entity type:Organization
Organization Name:ROBERT J MULCARE MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:MULCARE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-744-1515
Mailing Address - Street 1:3 EAST 74TH ST
Mailing Address - Street 2:SUITE 1E
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-2604
Mailing Address - Country:US
Mailing Address - Phone:212-744-1515
Mailing Address - Fax:212-744-1547
Practice Address - Street 1:3 EAST 74TH ST
Practice Address - Street 2:SUITE 1E
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-2604
Practice Address - Country:US
Practice Address - Phone:212-744-1515
Practice Address - Fax:212-744-1547
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0877712086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY001381473Medicaid
NY001381473Medicaid
915151Medicare ID - Type Unspecified