Healthcare Provider Details

I. General information

NPI: 1518999424
Provider Name (Legal Business Name): CHRISTINE A MITCHELL DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 09/03/2024
Certification Date: 09/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 PARKWAY # 2
KATONAH NY
10536-1505
US

IV. Provider business mailing address

131 PARKVIEW RD N
POUND RIDGE NY
10576-1213
US

V. Phone/Fax

Practice location:
  • Phone: 914-507-2909
  • Fax: 914-922-7457
Mailing address:
  • Phone: 443-280-0379
  • Fax: 914-922-7457

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License Number329146
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number329146
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: