Provider Demographics
NPI:1518151463
Name:MANDEL, REKHA J (MD)
Entity Type:Individual
Prefix:
First Name:REKHA
Middle Name:J
Last Name:MANDEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:REKHA
Other - Middle Name:
Other - Last Name:JAYAKUMAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:385 ROUTE 24 STE 1C
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:NJ
Mailing Address - Zip Code:07930-2908
Mailing Address - Country:US
Mailing Address - Phone:908-879-6660
Mailing Address - Fax:
Practice Address - Street 1:385 ROUTE 24 STE 1C
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:NJ
Practice Address - Zip Code:07930-2908
Practice Address - Country:US
Practice Address - Phone:908-879-6660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-04
Last Update Date:2020-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA09211000207R00000X
HIMD-14337207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI0000268813OtherHMSA BILLING NUMBER
HI0000268813OtherHMSA BILLING NUMBER