Provider Demographics
NPI:1235987090
Name:MITCHELL CABISUDO PHYSICIAN PC
Entity type:Organization
Organization Name:MITCHELL CABISUDO PHYSICIAN PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MITCHELL
Authorized Official - Middle Name:
Authorized Official - Last Name:CABISUDO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-888-6769
Mailing Address - Street 1:3125 US ROUTE 9W STE 204
Mailing Address - Street 2:
Mailing Address - City:NEW WINDSOR
Mailing Address - State:NY
Mailing Address - Zip Code:12553-6764
Mailing Address - Country:US
Mailing Address - Phone:845-888-6769
Mailing Address - Fax:518-708-6889
Practice Address - Street 1:3125 US ROUTE 9W STE 204
Practice Address - Street 2:
Practice Address - City:NEW WINDSOR
Practice Address - State:NY
Practice Address - Zip Code:12553-6764
Practice Address - Country:US
Practice Address - Phone:845-888-6769
Practice Address - Fax:518-708-6889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-07
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty