Basic Information
| Provider Information | |||||||||
| NPI: | 1568441533 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MITRANI-SCHWARTZ | ||||||||
| FirstName: | ANGELA | ||||||||
| MiddleName: | |||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 222 STATION PLZ N | ||||||||
| Address2: | SUITE 310 | ||||||||
| City: | MINEOLA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 115013808 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5166633822 | ||||||||
| FaxNumber: | 5166634740 | ||||||||
| Practice Location | |||||||||
| Address1: | 222 STATION PLZ N | ||||||||
| Address2: | SUITE 310 | ||||||||
| City: | MINEOLA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 115013808 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5166632051 | ||||||||
| FaxNumber: | 5166634740 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/10/2006 | ||||||||
| LastUpdateDate: | 06/08/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/08/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 190111 | NY | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | NYS185298 | NY | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 1307769 | 01 | FIRSTHEALTH | OTHER | 431925H | 01 | CIGNA | OTHER | 98J851 | 01 | BCBS | OTHER | AP799 | 01 | OXFORD | OTHER | 1224162 | 01 | UNITED HEALTHCARE | OTHER | 110185211 | 01 | RAILROAD MEDICARE | OTHER | D1561164 | 05 | NY | MEDICAID | 4616654 | 01 | AETNA | OTHER | 49040 | 01 | VYTRA | OTHER | OC6398 | 01 | HEALTHNET | OTHER | 2504964 | 01 | GHI | OTHER |