| Mitchell Cabisudo Physician Pc | |
|
3125 Us Route 9w Ste 204 New Windsor NY 12553-6764 | |
| (845) 888-6769 | |
| (518) 708-6889 |
| Full Name | Mitchell Cabisudo Physician Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 3125 Us Route 9w Ste 204, New Windsor, New York |
| Authorized Official Name and Position | Mitchell Cabisudo (CEO) |
| Authorized Official Contact | 8458886769 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mitchell Cabisudo Physician Pc 3125 Us Route 9w Ste 204 New Windsor NY 12553-6764 Ph: (845) 888-6769 | Mitchell Cabisudo Physician Pc 3125 Us Route 9w Ste 204 New Windsor NY 12553-6764 Ph: (845) 888-6769 |
| NPI Number | 1235987090 |
|---|---|
| Provider Enumeration Date | 05/07/2024 |
| Last Update Date | 05/07/2024 |
| Certification Date | 05/07/2024 |
| Medicare PECOS PAC ID | 5294271342 |
|---|---|
| Medicare Enrollment ID | O20240724004286 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235987090 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0804X | Psychiatry & Neurology - Child & Adolescent Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Mitchell T Cabisudo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1801055561 PECOS PAC ID: 2365627494 Enrollment ID: I20110505000255 |
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