Provider Demographics
NPI:1447390877
Name:MITCHELL, PATRICIA ANN (APRN,BC)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:ANN
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:APRN,BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 BULL MILL RD
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:10918-2647
Mailing Address - Country:US
Mailing Address - Phone:845-781-7471
Mailing Address - Fax:845-781-7471
Practice Address - Street 1:255 W 43RD ST
Practice Address - Street 2:TIMES SQUARE, CUCS, MEDICAL SUITE
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10036-3917
Practice Address - Country:US
Practice Address - Phone:212-391-5970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF304084-1363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF304084-1OtherANP LICENSE
NYMM1237507OtherDEA