Provider Demographics
NPI:1225601727
Name:MANDAL MEDICAL CARE PLLC
Entity type:Organization
Organization Name:MANDAL MEDICAL CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KAUSHIK
Authorized Official - Middle Name:
Authorized Official - Last Name:MANDAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-664-4158
Mailing Address - Street 1:14 RAYMOND ST
Mailing Address - Street 2:
Mailing Address - City:HICKSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11801-4332
Mailing Address - Country:US
Mailing Address - Phone:917-664-4158
Mailing Address - Fax:
Practice Address - Street 1:230 HILTON AVE STE 106
Practice Address - Street 2:
Practice Address - City:HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11550-8116
Practice Address - Country:US
Practice Address - Phone:516-416-4060
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-21
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty