Provider Demographics
NPI:1962582460
Name:MANDEL, ELISA BETH (MD)
Entity type:Individual
Prefix:DR
First Name:ELISA
Middle Name:BETH
Last Name:MANDEL
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:847 EASTON RD
Mailing Address - Street 2:SUITE 2500
Mailing Address - City:WARRINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:18976-2906
Mailing Address - Country:US
Mailing Address - Phone:215-918-5555
Mailing Address - Fax:215-918-5560
Practice Address - Street 1:847 EASTON RD
Practice Address - Street 2:SUITE 2500
Practice Address - City:WARRINGTON
Practice Address - State:PA
Practice Address - Zip Code:18976-2906
Practice Address - Country:US
Practice Address - Phone:215-918-5555
Practice Address - Fax:215-918-5560
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2008-06-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD048451L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAP00075057OtherRAILROAD MEDICARE
PA4559874OtherAETNA PPO
PA7761723OtherCIGNA
PA0660458000OtherKEYSTONE HEALTHPLAN
PA0475493OtherAETNA HMO
PA040729OtherBLUE SHIELD
PAP00075057OtherRAILROAD MEDICARE
PAF60665Medicare UPIN