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General NPI Number Information
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NPI Number | 1902081011
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Entity Type | Organization
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Legal Business Name | SILVIO A MANDARA MD
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Dates
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Enumeration Date | 01/08/2008
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Last Update Date | 01/08/2008
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Provider Practice Location Address
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Address Line | 27 OAK ST
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City | STAMFORD
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State | CT
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Zip | 06905-5342
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Country | US
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Telephone | 203-324-2263
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Fax |
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Provider Business Mailing Address
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Address Line | 27 OAK ST
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City | STAMFORD
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State | CT
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Zip | 06905-5342
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Country | US
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Telephone | 203-324-2263
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SILVIO A MANDARA
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Credential | MD
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Telephone | 203-324-2263
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | 02281
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License Number State | CT
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