Provider Demographics
NPI:1013022797
Name:MANDEL, YULIYA P (MD)
Entity type:Individual
Prefix:
First Name:YULIYA
Middle Name:P
Last Name:MANDEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6 TSIENNETO RD STE 300
Mailing Address - Street 2:
Mailing Address - City:DERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03038-1584
Mailing Address - Country:US
Mailing Address - Phone:036-216-0400
Mailing Address - Fax:603-216-3800
Practice Address - Street 1:6 TSIENNETO RD STE 300
Practice Address - Street 2:
Practice Address - City:DERRY
Practice Address - State:NH
Practice Address - Zip Code:03038-1584
Practice Address - Country:US
Practice Address - Phone:036-216-0400
Practice Address - Fax:603-216-3800
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA230168207Q00000X
NH33691207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAA40995Medicare PIN
MAA40995Medicare PIN