Provider Demographics
NPI:1356878003
Name:MANDRAYAR, LINDSEY LEE (PA)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:LEE
Last Name:MANDRAYAR
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:156 W 56TH ST STE 1000D
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-3936
Mailing Address - Country:US
Mailing Address - Phone:646-586-9908
Mailing Address - Fax:
Practice Address - Street 1:156 W 56TH ST STE 1000D
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-3936
Practice Address - Country:US
Practice Address - Phone:646-586-9908
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-12
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027546363A00000X
WAPA61437325363A00000X
NC0010-12896363A00000X
SC4794363A00000X
GA11634363A00000X
TXPA16305363A00000X
VA0110005785363A00000X
COPA.0007805363A00000X
VA110005785363A00000X
AZ9080363A00000X
NVPA2743363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner