Healthcare Provider Details

I. General information

NPI: 1932490554
Provider Name (Legal Business Name): MICHAEL THOMAS KITCHELL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/30/2011
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

90 S BEDFORD RD
MOUNT KISCO NY
10549-3412
US

IV. Provider business mailing address

90 S BEDFORD RD
MOUNT KISCO NY
10549-3412
US

V. Phone/Fax

Practice location:
  • Phone: 914-242-1370
  • Fax: 914-242-2779
Mailing address:
  • Phone: 914-242-1370
  • Fax: 914-242-2779

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD.206535
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: