Provider Demographics
NPI:1134292881
Name:MANDARA, SILVIO ALEXANDER (MD)
Entity Type:Individual
Prefix:
First Name:SILVIO
Middle Name:ALEXANDER
Last Name:MANDARA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 OAK ST
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06905-5342
Mailing Address - Country:US
Mailing Address - Phone:203-324-2262
Mailing Address - Fax:
Practice Address - Street 1:27 OAK ST
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06905-5342
Practice Address - Country:US
Practice Address - Phone:203-324-2262
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT22881207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology