Provider Demographics
NPI:1548642499
Name:MULLER, KATHERINE (LAC)
Entity type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:
Last Name:MULLER
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:MRS
Other - First Name:KATHERINE
Other - Middle Name:
Other - Last Name:TALBOT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LAC
Mailing Address - Street 1:2586 HEWLETT LN
Mailing Address - Street 2:
Mailing Address - City:BELLMORE
Mailing Address - State:NY
Mailing Address - Zip Code:11710-4413
Mailing Address - Country:US
Mailing Address - Phone:516-996-3629
Mailing Address - Fax:
Practice Address - Street 1:2586 HEWLETT LN
Practice Address - Street 2:
Practice Address - City:BELLMORE
Practice Address - State:NY
Practice Address - Zip Code:11710-4413
Practice Address - Country:US
Practice Address - Phone:516-996-3629
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-26
Last Update Date:2015-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005557171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist