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NPI Code Detail

MEDICARE: RON MITZNER M.D.

MEDICARE: RON MITZNER M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Y00000XOtolaryngology PhysicianMT188339PA
2207Y00000XOtolaryngology Physician260623NY

General Provider Information

NPI Number : 1083828495
Entity Type Code : Individual
Provider Name (Legal Business Name) : RON MITZNER M.D.
Provider Business Mailing Address
First Line : 660 WHITE PLAINS RD FL 4
Second Line :
City : TARRYTOWN
State : NY
Zip : 10591-5139
Country : US
Telephone Number : 914-984-2546
Fax Number :
Provider Business Practice Location Address
First Line : 6 OHIO DR STE 202
Second Line :
City : NEW HYDE PARK
State : NY
Zip : 11042-1129
Country : US
Telephone Number : 516-775-2800
Fax Number : 516-775-0859
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/09/2007
Last Update Date : 09/02/2021

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