Provider Demographics
NPI:1528243466
Name:MIGDEN, MITCHELL (RPH)
Entity type:Individual
Prefix:MR
First Name:MITCHELL
Middle Name:
Last Name:MIGDEN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:239 E. HUNTING RIDGE RD.
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06903-2318
Mailing Address - Country:US
Mailing Address - Phone:203-329-3580
Mailing Address - Fax:
Practice Address - Street 1:239 E HUNTING RIDGE RD
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06903-2318
Practice Address - Country:US
Practice Address - Phone:203-329-3580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-09
Last Update Date:2008-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY34841183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY34841OtherLICENSE NUMBER