Provider Demographics
NPI:1477050722
Name:MANDARO, CLARE REID (DO)
Entity type:Individual
Prefix:
First Name:CLARE
Middle Name:REID
Last Name:MANDARO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:CLARE
Other - Middle Name:REID
Other - Last Name:BOZSO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:420 LAKEVILLE RD
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11042-1121
Mailing Address - Country:US
Mailing Address - Phone:718-470-3480
Mailing Address - Fax:
Practice Address - Street 1:269-01 76TH AVENUE
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040
Practice Address - Country:US
Practice Address - Phone:718-470-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-11
Last Update Date:2025-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY317053-01208000000X, 2080P0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases
No208000000XAllopathic & Osteopathic PhysiciansPediatrics