Provider Demographics
NPI:1427154293
Name:MANDEL, HARVEY J (MD)
Entity type:Individual
Prefix:DR
First Name:HARVEY
Middle Name:J
Last Name:MANDEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3725 HENRY HUDSON PKWY
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-1527
Mailing Address - Country:US
Mailing Address - Phone:718-796-9600
Mailing Address - Fax:718-796-9601
Practice Address - Street 1:3725 HENRY HUDSON PKWY
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-1527
Practice Address - Country:US
Practice Address - Phone:718-796-9600
Practice Address - Fax:718-796-9601
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY098106207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00166409Medicaid
NY961781Medicare ID - Type Unspecified
NY00166409Medicaid