Provider Demographics
NPI:1215075908
Name:MANDELBAUM, CHAIM Y (MD)
Entity type:Individual
Prefix:DR
First Name:CHAIM
Middle Name:Y
Last Name:MANDELBAUM
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:75 MAIDEN LN
Mailing Address - Street 2:SUITE 1206
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10038-4810
Mailing Address - Country:US
Mailing Address - Phone:646-602-8030
Mailing Address - Fax:646-602-9154
Practice Address - Street 1:75 MAIDEN LN
Practice Address - Street 2:SUITE 1206
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10038-4810
Practice Address - Country:US
Practice Address - Phone:212-995-6495
Practice Address - Fax:212-844-6772
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2023-04-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY193523207L00000X, 207LA0401X, 207LH0002X, 207LP2900X, 208VP0000X, 208VP0014X, 2083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LA0401XAllopathic & Osteopathic PhysiciansAnesthesiologyAddiction Medicine
No207LH0002XAllopathic & Osteopathic PhysiciansAnesthesiologyHospice and Palliative Medicine
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP00219281OtherMEDICARE RAILROAD
NY02338136Medicaid
NY175327OtherELDERPLAN
NYCM032P6130OtherEMPIRE BCBS-MANHATTAN
NYN82711OtherHEALTHNET
NYP2676389OtherOXFORD HEALTH PLANS
NY2889995OtherCIGNA
NYCM03N02910OtherEMPIRE BCBS-BROOKLYN
NY5303223OtherGROUP HEALTH INCORPORATED
NY7589421OtherAETNA
NYCM03N02910OtherEMPIRE BCBS-BROOKLYN
NY2889995OtherCIGNA
NYP2676389OtherOXFORD HEALTH PLANS