Provider Demographics
NPI:1578594941
Name:MANDAL, APARNA (MD)
Entity Type:Individual
Prefix:
First Name:APARNA
Middle Name:
Last Name:MANDAL
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 1:436 COMMONS WAY UNIT 436D
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-6428
Mailing Address - Country:US
Mailing Address - Phone:732-569-6505
Mailing Address - Fax:732-998-8321
Practice Address - Street 1:436 COMMONS WAY UNIT 436D
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-6428
Practice Address - Country:US
Practice Address - Phone:732-569-6505
Practice Address - Fax:732-998-8321
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07190100207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8647402Medicaid
NJ8647402Medicaid
NJ051957Medicare ID - Type Unspecified