MEDICARE: DR AARON MANDEL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist
2	332H00000X	Eyewear Supplier

General Provider Information

NPI Number	:	1609025014
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR AARON MANDEL

Provider Business Mailing Address
First Line	:	228 LIVINGSTON ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11201-5859
Country	:	US
Telephone Number	:	718-625-2137
Fax Number	:	718-875-8080

Provider Business Practice Location Address
First Line	:	228 LIVINGSTON ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11201-5859
Country	:	US
Telephone Number	:	718-625-2137
Fax Number	:	718-875-8080

Authorized Official
Title or Position	:	OWNER
Name	:	DR. AARON MANDEL
Credential	:	O. D.
Telephone Number	:	718-625-2137

Provider Enumeration Date	:	09/10/2008
Last Update Date	:	09/10/2008

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Directions to “DR AARON MANDEL ” Practice Location

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