Provider Demographics
NPI:1841630050
Name:MANDEL, ROBERT WILLIAM (DO)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:WILLIAM
Last Name:MANDEL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3970 PERKIOMEN AVENUE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19606-2719
Mailing Address - Country:US
Mailing Address - Phone:610-779-1330
Mailing Address - Fax:610-779-7699
Practice Address - Street 1:410 EAST PENN AVENUE
Practice Address - Street 2:
Practice Address - City:ROBESONIA
Practice Address - State:PA
Practice Address - Zip Code:19551-9014
Practice Address - Country:US
Practice Address - Phone:484-987-3456
Practice Address - Fax:610-743-3143
Is Sole Proprietor?:No
Enumeration Date:2013-07-02
Last Update Date:2018-03-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOS017349207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine