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Export Provider Record NPI 1063405025
Michael J MulvaneyM.D.
Active
NPI Number1063405025
NPI TypeNPI-1 Individual
SpecialtyDermatology, MOHS-Micrographic Surgery
Provider Details
NPI1063405025
NPI TypeNPI-1 Individual
StatusActive
Enumeration Date2005-08-25
Last Updated2022-06-15
Mailing Address264 Washington Avenue Ext Ste 201
Albany, NY 12203-6352
United States
Phone: (518) 452-1928 | Fax: (518) 362-1348
📍 View Map
Primary Practice Address264 Washington Avenue Ext Ste 201
Albany, NY 12203
United States
Phone: (518) 452-1928 | Fax: (518) 362-1348
📍 View Map
Other Identifiers
IssuerStateNumberOther Issuer
Other (non-Medicare)NY1823931NYLicense
Taxonomy / Specialty
PrimaryTaxonomy Code & DescriptionStateLicense Number
No174400000X – Specialist
No207ND0101X – Dermatology, MOHS-Micrographic SurgeryNY182393
Yes207ND0101X – Dermatology, MOHS-Micrographic SurgeryNY182393-1
Export Provider Record NPI 1063405025
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About NPI 1063405025

Michael J Mulvaney M.D. is a healthcare provider registered in the CMS NPPES NPI Registry with NPI number 1063405025. The primary specialty listed is Dermatology, MOHS-Micrographic Surgery. The provider is located in Albany, NY. This NPI is classified as a Type 1 (Individual) NPI and is currently active. The NPI was first enumerated (assigned) on 2005-08-25. All data is sourced directly from the official CMS NPPES public API and is updated daily.

Frequently Asked Questions

What is NPI 1063405025?

NPI 1063405025 belongs to Michael J Mulvaney M.D., a Dermatology, MOHS-Micrographic Surgery in Albany, NY. It is a Type 1 Individual NPI registered in the CMS NPPES NPI Registry.

Is NPI 1063405025 active?

The current status of NPI 1063405025 in the NPPES registry is Active. The record was last updated on 2022-06-15.

What specialty is NPI 1063405025?

NPI 1063405025 is classified under the taxonomy Dermatology, MOHS-Micrographic Surgery. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.

How do I verify NPI 1063405025?

You can verify NPI 1063405025 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.

What address is on file for NPI 1063405025?

The primary practice address on file for NPI 1063405025 is 264 Washington Avenue Ext Ste 201, Albany, NY 12203. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.

When was NPI 1063405025 issued?

NPI 1063405025 was first issued (enumerated) on 2005-08-25. The NPPES record was last updated on 2022-06-15.

Practice Location Map

Michael J Mulvaney is located at 264 Washington Avenue Ext Ste 201, Albany, NY. Use the map below to find directions or verify the practice location.

📍 264 Washington Avenue Ext Ste 201, Albany, NY 12203  ·  Open in Google Maps ↗

Related Healthcare Providers

The following providers share the same practice location, specialty, or state as Michael J Mulvaney. All records sourced from the CMS NPPES registry.

License Information

The following state license numbers are on file in the NPPES registry for NPI 1063405025. For license status verification, contact the relevant state licensing board directly.

Specialty / TaxonomyLicense NumberState
Dermatology, MOHS-Micrographic Surgery182393NY
Dermatology, MOHS-Micrographic Surgery182393-1NY
Data Verified from CMS NPPES Last synced: 2026-06-16 · Source: npiregistry.cms.hhs.gov · 45 CFR Part 162