Provider Demographics
NPI:1013022797
Name:MANDEL, YULIYA P (MD)
Entity Type:Individual
Prefix:
First Name:YULIYA
Middle Name:P
Last Name:MANDEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:298 WASHINGTON ST FL 4
Mailing Address - Street 2:
Mailing Address - City:GLOUCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01930-4832
Mailing Address - Country:US
Mailing Address - Phone:978-283-7580
Mailing Address - Fax:978-283-0456
Practice Address - Street 1:298 WASHINGTON ST FL 4
Practice Address - Street 2:
Practice Address - City:GLOUCESTER
Practice Address - State:MA
Practice Address - Zip Code:01930-4832
Practice Address - Country:US
Practice Address - Phone:978-283-7580
Practice Address - Fax:978-283-0456
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2019-10-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA230168207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAA40995Medicare PIN
MAA40995Medicare PIN