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General NPI Number Information
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NPI Number | 1841630050
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Entity Type | Individual
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Provider Name | ROBERT WILLIAM MANDEL D.O.
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Gender | Male
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Dates
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Enumeration Date | 07/02/2013
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Last Update Date | 03/12/2018
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Provider Practice Location Address
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Address Line | 410 EAST PENN AVENUE
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City | ROBESONIA
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State | PA
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Zip | 19551-9014
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Country | US
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Telephone | 484-987-3456
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Fax | 610-743-3143
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Provider Business Mailing Address
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Address Line | 3970 PERKIOMEN AVENUE SUITE 102
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City | READING
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State | PA
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Zip | 19606-2719
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Country | US
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Telephone | 610-779-1330
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Fax | 610-779-7699
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS017349
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License Number State | PA
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