Provider Demographics
NPI:1821297227
Name:MANDELBLAT, JULIA (MD)
Entity Type:Individual
Prefix:DR
First Name:JULIA
Middle Name:
Last Name:MANDELBLAT
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 1:450 CLARKSON AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-2056
Mailing Address - Country:US
Mailing Address - Phone:718-270-2785
Mailing Address - Fax:718-270-1578
Practice Address - Street 1:7 STONER AVE
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-2150
Practice Address - Country:US
Practice Address - Phone:917-601-0824
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-16
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY232644207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology