Provider Demographics
NPI:1790732170
Name:SANAT K.MANDAL M.D. ASSOCIATES
Entity Type:Organization
Organization Name:SANAT K.MANDAL M.D. ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SANAT
Authorized Official - Middle Name:KUMAR
Authorized Official - Last Name:MANDAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-829-3530
Mailing Address - Street 1:829 SPRUCE ST
Mailing Address - Street 2:SUITE 105
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-5752
Mailing Address - Country:US
Mailing Address - Phone:215-829-3530
Mailing Address - Fax:215-829-3090
Practice Address - Street 1:829 SPRUCE ST
Practice Address - Street 2:SUITE 105
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-5752
Practice Address - Country:US
Practice Address - Phone:215-829-3530
Practice Address - Fax:215-829-3090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA066260Medicare ID - Type UnspecifiedMEDICARE GROUP