Provider Demographics
NPI:1275832412
Name:MANGAT, SIMMANJEET (MD)
Entity Type:Individual
Prefix:DR
First Name:SIMMANJEET
Middle Name:
Last Name:MANGAT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 10TH ST STE 704
Mailing Address - Street 2:
Mailing Address - City:NIAGARA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14301-1841
Mailing Address - Country:US
Mailing Address - Phone:716-278-4151
Mailing Address - Fax:716-278-4706
Practice Address - Street 1:620 10TH ST STE 704
Practice Address - Street 2:
Practice Address - City:NIAGARA FALLS
Practice Address - State:NY
Practice Address - Zip Code:14301-1841
Practice Address - Country:US
Practice Address - Phone:716-278-4151
Practice Address - Fax:716-278-4706
Is Sole Proprietor?:No
Enumeration Date:2011-03-25
Last Update Date:2020-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY275933207R00000X
FLME144605207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine