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General NPI Number Information
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NPI Number | 1134388184
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Entity Type | Organization
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Legal Business Name | MICHAEL MANDELL M.D. OB/GYN
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Dates
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Enumeration Date | 06/05/2008
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Last Update Date | 06/10/2008
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Provider Practice Location Address
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Address Line | 66 SUNSET STRIP STE 302
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City | SUCCASUNNA
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State | NJ
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Zip | 07876-1362
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Country | US
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Telephone | 973-584-5600
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Fax |
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Provider Business Mailing Address
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Address Line | 3 ROBIN DR
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City | DENVILLE
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State | NJ
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Zip | 07834-3619
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Country | US
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Telephone | 973-366-0211
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Fax |
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. MICHAEL MANDELL
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Credential | M.D.
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Telephone | 973-584-5600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 25MA02384800
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License Number State | NJ
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