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General NPI Number Information
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NPI Number | 1043425267
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Entity Type | Organization
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Legal Business Name | ALEX MANDEL, M.D.
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Dates
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Enumeration Date | 05/11/2007
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Last Update Date | 02/09/2016
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Provider Practice Location Address
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Address Line | 400 MASSASOIT AVE SUITE 300
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City | EAST PROVIDENCE
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State | RI
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Zip | 02914-2012
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Country | US
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Telephone | 401-434-8226
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Fax | 401-434-4178
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Provider Business Mailing Address
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Address Line | 400 MASSASOIT AVE SUITE 300
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City | EAST PROVIDENCE
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State | RI
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Zip | 02914-2012
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Country | US
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Telephone | 401-434-8226
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Fax | 401-434-4178
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Authorized Official
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Title or Position | OWNER
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Name | DR. ALEX MANDEL
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Credential | MD
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Telephone | 401-434-8226
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD05393
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License Number State | RI
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