Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 294409 | NY |
NPI | 1700296142 |
---|---|
Provider Name | Linda Renee Mitchell |
First Address | Bronx, NY 10467 |
Second Address | Bronx, NY 10467-2401 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2014 |
Last Update Date | 24/01/2020 |