MEDICARE: DR. MITCHELL S GARDEN MD

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
1	174400000X	Specialist	044118	CT
2	207XS0117X	Orthopaedic Surgery of the Spine Physician	044118	CT
3	207X00000X	Orthopaedic Surgery Physician	044118	CT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000038402	OTHER	NY	GHI HMO #
2	2071599	OTHER	NY	AETNA HMO #
3	5724688	OTHER	NY	AETNA PPO #
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	0599833	OTHER	NY	GHI PPO #
6	141796305	OTHER	NY	TAX IDENTIFICATION #
7	691155	OTHER	NY	MVP PROVIDER #
8	P958616	OTHER	NY	OXFORD PROVIDER #

General Provider Information

NPI Number	:	1952304263
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MITCHELL S GARDEN MD

Provider Business Mailing Address
First Line	:	538 LITCHFIELD ST STE 202
Second Line	:
City	:	TORRINGTON
State	:	CT
Zip	:	06790-6669
Country	:	US
Telephone Number	:	860-361-6650
Fax Number	:	860-361-6654

Provider Business Practice Location Address
First Line	:	538 LITCHFIELD ST STE 202
Second Line	:
City	:	TORRINGTON
State	:	CT
Zip	:	06790-6669
Country	:	US
Telephone Number	:	860-361-6650
Fax Number	:	860-361-6654

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/31/2005
Last Update Date	:	08/30/2024

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Directions to “ DR. MITCHELL S GARDEN MD” Practice Location

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