Individual
MR. MARK SAMUEL MANDELCORN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
301 STERLING DRIVE, ORCHARD PARK, NY 14127-1570
(716) 677-6500
(716) 677-6507
Mailing address
301 STERLING DRIVE, ORCHARD PARK, NY 14127-1570
(716) 677-6500
(716) 677-6507
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
188981
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000511371002
HEALTH NOW NEW YORK
NY
05
—
01843109
—
NY
01
—
0807246
INDEPENDENT HEALTH
NY
Enumeration date
05/08/2006
Last updated
07/08/2007
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