Doctor Name: | DR. MATTHEW JOSEPH MITCHELL |
NPI Number: | 1083027270 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PH.D. |
License Number: | 021323 |
Business Practice Address: | 36 Smith Ave Mount Kisco, NY - 105492800 |
Business Phone Number: | 6464944902 |
Business Fax Number: | |
Mailing Address: | 36 Smith Ave, MOUNT KISCO |
State: | NY |
Postal Code: | 105492800 |
Phone Number: | 6464944902 |
Fax Number: | |
NPI Enumeration Date: | 06/05/2014 |
NPI Last Update Date: | 05/25/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 021323 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |