Healthcare Provider Details

I. General information

NPI: 1669446399
Provider Name (Legal Business Name): MITCHELL S CAIRO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/17/2006
Last Update Date: 01/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 BRADHURST AVE SUITE 800
HAWTHORNE NY
10532
US

IV. Provider business mailing address

50 PLAZA WEST MUNGER PAVILION, ROOM 110
VALHALLA NY
10595
US

V. Phone/Fax

Practice location:
  • Phone: 914-594-3650
  • Fax: 914-594-3803
Mailing address:
  • Phone: 914-594-3650
  • Fax: 914-594-3803

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License Number217898
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: