Healthcare Provider Details

I. General information

NPI: 1063413532
Provider Name (Legal Business Name): MITCHELL JOSEPHS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2005
Last Update Date: 03/12/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1985 CROMPOND RD BUILDING D
CORTLANDT MANOR NY
10567-4146
US

IV. Provider business mailing address

64 UNDERHILL RD
OSSINING NY
10562-5104
US

V. Phone/Fax

Practice location:
  • Phone: 914-739-2400
  • Fax: 914-739-2691
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number194981-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number194981
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: