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General NPI Number Information
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NPI Number | 1225601727
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Entity Type | Organization
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Legal Business Name | MANDAL MEDICAL CARE PLLC
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Dates
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Enumeration Date | 07/21/2021
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Last Update Date | 03/21/2022
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Provider Practice Location Address
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Address Line | 230 HILTON AVE STE 106
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City | HEMPSTEAD
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State | NY
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Zip | 11550-8116
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Country | US
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Telephone | 516-416-4060
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Fax |
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Provider Business Mailing Address
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Address Line | 14 RAYMOND ST
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City | HICKSVILLE
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State | NY
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Zip | 11801-4332
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Country | US
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Telephone | 917-664-4158
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | KAUSHIK MANDAL
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Credential | MD
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Telephone | 917-664-4158
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number |
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License Number State |
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