Provider Demographics
NPI:1598714768
Name:MANGELS, RALPH (DC)
Entity Type:Individual
Prefix:DR
First Name:RALPH
Middle Name:
Last Name:MANGELS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 MONTAUK HWY
Mailing Address - Street 2:PO BOX 9182
Mailing Address - City:BAY SHORE
Mailing Address - State:NY
Mailing Address - Zip Code:11706-8403
Mailing Address - Country:US
Mailing Address - Phone:631-758-4444
Mailing Address - Fax:631-758-1984
Practice Address - Street 1:280 MONTAUK HWY
Practice Address - Street 2:
Practice Address - City:BAY SHORE
Practice Address - State:NY
Practice Address - Zip Code:11706-8403
Practice Address - Country:US
Practice Address - Phone:631-758-4444
Practice Address - Fax:631-758-1984
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX006410111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYAA71544OtherMDNY
NYP1950185OtherOXFORD
NYX5C681Medicare ID - Type Unspecified
NYU79893Medicare UPIN