Provider Demographics
NPI:1780083659
Name:MITTENTHAL, APRIL (MSED)
Entity type:Individual
Prefix:MRS
First Name:APRIL
Middle Name:
Last Name:MITTENTHAL
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1323 ESTATES LN
Mailing Address - Street 2:
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11360-1179
Mailing Address - Country:US
Mailing Address - Phone:917-886-3361
Mailing Address - Fax:
Practice Address - Street 1:1323 ESTATES LN
Practice Address - Street 2:
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11360-1179
Practice Address - Country:US
Practice Address - Phone:917-886-3361
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-17
Last Update Date:2014-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY843093142174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist