Provider Demographics
NPI:1578592929
Name:MITCHELL, ROBERT ALEXANDER (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:ALEXANDER
Last Name:MITCHELL
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 1:806 KARENWALD LN
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12309-6414
Mailing Address - Country:US
Mailing Address - Phone:518-382-5660
Mailing Address - Fax:518-377-9222
Practice Address - Street 1:806 KARENWALD LN
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12309-6414
Practice Address - Country:US
Practice Address - Phone:518-382-5660
Practice Address - Fax:518-377-9222
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0854932084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYC49740Medicare UPIN
NY38830GMedicare ID - Type Unspecified