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Organization
RICHARD MANDELBAUM MD PC
Active
Organization
RICHARD MANDELBAUM MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD I MANDELBAUM MD (OWNER)
(718) 384-6365
Entity
Organization
Contact information
Practice address
164 CLYMER ST, BROOKLYN, NY 11211-7104
(718) 384-6365
(206) 202-2774
Mailing address
164 CLYMER ST, BROOKLYN, NY 11211-7104
(718) 384-6365
(206) 202-2774
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
206316
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01817972
—
NY
01
—
1407887805
NPI
—
01
—
G71728
UPIN
—
Enumeration date
04/01/2008
Last updated
12/31/2013
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