Individual
MR. GARY MITKOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPAC
Contact information
Practice address
1 TITUS PLACE, WALTON, NY 13856
(607) 865-2188
(607) 865-2238
Mailing address
1 TITUS PLACE, WALTON, NY 13856
(607) 865-2188
(607) 865-2238
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
007054
NY
Other
Enumeration date
11/29/2006
Last updated
07/08/2007
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