Provider Demographics
NPI:1942232210
Name:MANDEL, SEAN BENJAMIN (DC)
Entity Type:Individual
Prefix:DR
First Name:SEAN
Middle Name:BENJAMIN
Last Name:MANDEL
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 1:6 MYSTIC LN
Mailing Address - Street 2:
Mailing Address - City:MALVERN
Mailing Address - State:PA
Mailing Address - Zip Code:19355-1942
Mailing Address - Country:US
Mailing Address - Phone:267-258-6246
Mailing Address - Fax:610-889-1316
Practice Address - Street 1:6 MYSTIC LN
Practice Address - Street 2:
Practice Address - City:MALVERN
Practice Address - State:PA
Practice Address - Zip Code:19355-1942
Practice Address - Country:US
Practice Address - Phone:610-889-9244
Practice Address - Fax:610-889-1316
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2013-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC008976111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor