Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | A52383278-8123 | CT |
Y | 208600000X | Surgeon | A52383278-8123 | CT |
N | 2086X0206X | Surgical Oncologist | 249754-1 | NY |
NPI | 1003070681 |
---|---|
Provider Name | Sunny D Mitchell |
First Address | New York, NY 10032-3729 |
Second Address | New York, NY 10032-3729 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2008 |
Last Update Date | 05/11/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
WWR581 | GRP MED# (01) | NY |