Provider Demographics
NPI:1396850053
Name:STRAND, MITCHELL S (MD)
Entity Type:Individual
Prefix:
First Name:MITCHELL
Middle Name:S
Last Name:STRAND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:484 TEMPLE HILL RD
Mailing Address - Street 2:STE 102
Mailing Address - City:NEW WINDSOR
Mailing Address - State:NY
Mailing Address - Zip Code:12553-5557
Mailing Address - Country:US
Mailing Address - Phone:845-565-3700
Mailing Address - Fax:845-565-3395
Practice Address - Street 1:60 PROSPECT AVE
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10940-4133
Practice Address - Country:US
Practice Address - Phone:845-342-7115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY163018207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00988096Medicaid
NYA62958Medicare UPIN
NY48D881Medicare ID - Type Unspecified