Provider Demographics
NPI:1962663047
Name:MANDELKER, LISA GOLDA (DO)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:GOLDA
Last Name:MANDELKER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:145 HUGUENOT ST STE 200
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801-5200
Mailing Address - Country:US
Mailing Address - Phone:914-235-1400
Mailing Address - Fax:914-235-1534
Practice Address - Street 1:145 HUGUENOT ST STE 200
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-5200
Practice Address - Country:US
Practice Address - Phone:914-235-1400
Practice Address - Fax:914-235-1534
Is Sole Proprietor?:No
Enumeration Date:2008-06-20
Last Update Date:2012-01-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY247364208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics