Provider Demographics
NPI:1821255183
Name:MANDEL, MATTHEW JEFFREY (MD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:JEFFREY
Last Name:MANDEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 BERKSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-5501
Mailing Address - Country:US
Mailing Address - Phone:917-364-4383
Mailing Address - Fax:
Practice Address - Street 1:9 BERKSHIRE DR
Practice Address - Street 2:
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-5501
Practice Address - Country:US
Practice Address - Phone:917-364-4383
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-22
Last Update Date:2010-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2419602084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology