Provider Demographics
NPI:1093759409
Name:MANGEL, JOSEPH (DO)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:MANGEL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 MCKEAN ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19148-2627
Mailing Address - Country:US
Mailing Address - Phone:215-755-2500
Mailing Address - Fax:215-755-3890
Practice Address - Street 1:201 MCKEAN ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19148-2627
Practice Address - Country:US
Practice Address - Phone:215-755-2500
Practice Address - Fax:215-755-3890
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2007-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS007738L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0015018140002Medicaid
PA560936Medicare PIN
PA0015018140002Medicaid
PAF93750Medicare UPIN