Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 260623 | NY |
N | 207Y00000X | Otolaryngologist (ENT Doctor) | MT188339 | PA |
NPI | 1083828495 |
---|---|
Provider Name | Ron Mitzner |
First Address | Tarrytown, NY 10591-5139 |
Second Address | New Hyde Park, NY 11042-1129 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2007 |
Last Update Date | 02/09/2021 |