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General NPI Number Information
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NPI Number | 1780997049
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Entity Type | Individual
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Provider Name | JENNIFER MANDELL DPT
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Gender | Female
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Dates
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Enumeration Date | 07/15/2010
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Last Update Date | 06/06/2023
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Provider Practice Location Address
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Address Line | 148 MAIN ST STE 3
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City | LEBANON
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State | NJ
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Zip | 08833-2157
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Country | US
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Telephone | 908-257-0602
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Fax |
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Provider Business Mailing Address
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Address Line | 8 COLONIAL CT
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City | LEBANON
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State | NJ
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Zip | 08833-4100
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Country | US
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Telephone | 908-917-4717
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 40QA01357000
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 40QA01357000
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License Number State | NJ
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