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Individual

ANGELO J MITSOS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
3124 WILMINGTON RD, SUITE 106, NEW CASTLE, PA 16105-1100
(724) 656-1680
(724) 656-1683
Mailing address
3124 WILMINGTON RD, SUITE 106, NEW CASTLE, PA 16105-1100
(724) 656-1680
(724) 656-1683

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
SC002342L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0008523790004
PA
01
0488422
MEDICAID PIN
OH
01
PO0329085
RAILROAD MEDICARE PIN
OH
Enumeration date
11/10/2005
Last updated
02/22/2012
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