Provider Demographics
NPI:1710010590
Name:MANDEL, NECHAMA (MSPT)
Entity Type:Individual
Prefix:MS
First Name:NECHAMA
Middle Name:
Last Name:MANDEL
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 NEPTUNE AVE
Mailing Address - Street 2:
Mailing Address - City:WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11598-1751
Mailing Address - Country:US
Mailing Address - Phone:917-418-8489
Mailing Address - Fax:
Practice Address - Street 1:77 NEPTUNE AVE
Practice Address - Street 2:
Practice Address - City:WOODMERE
Practice Address - State:NY
Practice Address - Zip Code:11598-1751
Practice Address - Country:US
Practice Address - Phone:917-418-8489
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2018-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025468225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist