Provider Demographics
NPI:1710194873
Name:BARDEN, MITCHELL S (MD)
Entity Type:Individual
Prefix:
First Name:MITCHELL
Middle Name:S
Last Name:BARDEN
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 1:35 CARRIAGE HILL LN
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12603-4233
Mailing Address - Country:US
Mailing Address - Phone:845-454-0930
Mailing Address - Fax:
Practice Address - Street 1:230 NORTH ROAD
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-1386
Practice Address - Country:US
Practice Address - Phone:845-486-2703
Practice Address - Fax:845-790-2199
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2012-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1309922084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry