Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | 24890 | MN |
NPI | 1205276797 |
---|---|
Provider Name | Dr. Richard Mitchell |
First Address | New York, NY 10022-1514 |
Second Address | New York, NY 10022-1514 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2013 |
Last Update Date | 27/06/2013 |