Provider Demographics
NPI:1255374567
Name:MANDEL, GILBERT B (MD)
Entity type:Individual
Prefix:
First Name:GILBERT
Middle Name:B
Last Name:MANDEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:16 POCONO ROAD
Mailing Address - Street 2:SUITE 317
Mailing Address - City:DENVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07834
Mailing Address - Country:US
Mailing Address - Phone:973-627-2650
Mailing Address - Fax:973-627-8383
Practice Address - Street 1:16 POCONO ROAD
Practice Address - Street 2:SUITE 317
Practice Address - City:DENVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07834
Practice Address - Country:US
Practice Address - Phone:973-627-2650
Practice Address - Fax:973-627-8383
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2010-02-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA02485600207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ060013940OtherCARDIOLOGY RR MEDICARE
NJ110120471OtherRAILROAD MEDICARE
31K271OtherWELLCHOICE
NJIP003OtherOXFORD
NJ0368903Medicaid
NJ526293OtherMEDICARE ID
NJ0316561011OtherCIGNA
NJ223297079OtherBCBS
NJ060013940OtherRR MEDI/CARDI
31K271OtherWELLCHOICE