Provider Demographics
NPI:1356050884
Name:MANDELL, GUISEPPE (PERR RECOVERY SUPPOR)
Entity type:Individual
Prefix:
First Name:GUISEPPE
Middle Name:
Last Name:MANDELL
Suffix:
Gender:M
Credentials:PERR RECOVERY SUPPOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 KAREN AVE STE B202
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89109-1274
Mailing Address - Country:US
Mailing Address - Phone:702-472-6248
Mailing Address - Fax:
Practice Address - Street 1:900 KAREN AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89109-1264
Practice Address - Country:US
Practice Address - Phone:702-290-9952
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-23
Last Update Date:2022-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist