Healthcare Provider Details

I. General information

NPI: 1356733125
Provider Name (Legal Business Name): NEIL S MANDEL PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/03/2015
Last Update Date: 03/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5000 W NATIONAL AVE RESEARCH DIVISION/151 VA MED CENTER/MED COLLEGE OF WI
MILWAUKEE WI
53295
US

IV. Provider business mailing address

5000 W NATIONAL AVE RESEARCH DIVISION/151 VA MED CENTER/MED COLLEGE OF WI
MILWAUKEE WI
53295
US

V. Phone/Fax

Practice location:
  • Phone: 414-384-2000
  • Fax: 414-382-5320
Mailing address:
  • Phone: 414-384-2000
  • Fax: 414-382-5320

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1744R1103X
TaxonomyResearch Study Abstracter/Coder
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: