Individual
KATIE MITASZKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1901 FIRST AVENUE, 12TH FLOOR ROOM 12A1, NEW YORK, NY 10029
(212) 423-7913
Mailing address
3920 GREENPOINT AVE APT 7J, SUNNYSIDE, NY 11104-4523
(508) 667-0500
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
023902
NY
Other
Enumeration date
06/24/2019
Last updated
10/07/2019
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