Provider Demographics
NPI:1275767675
Name:MITCHELL, AMBER NOELLE (MD)
Entity Type:Individual
Prefix:DR
First Name:AMBER
Middle Name:NOELLE
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1240 ULSTER AVE
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:NY
Mailing Address - Zip Code:12401-1517
Mailing Address - Country:US
Mailing Address - Phone:845-331-5165
Mailing Address - Fax:845-331-6238
Practice Address - Street 1:1240 ULSTER AVE
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-1517
Practice Address - Country:US
Practice Address - Phone:845-331-5165
Practice Address - Fax:845-331-6238
Is Sole Proprietor?:No
Enumeration Date:2009-05-13
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2761812084N0400X
CT665902084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology