Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | 254767 | NY |
NPI | 1134388259 |
---|---|
Provider Name | Dr. Joshua Theodore Mitgang |
First Address | Woodmere, NY 11598-2405 |
Second Address | Cedarhurst, NY 11516-2240 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2008 |
Last Update Date | 28/06/2017 |