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Individual

LAURA MANDELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2701 TAMARACK AVE, SOUTH WINDSOR, CT 06074-5562
(508) 259-6656
Mailing address
2701 TAMARACK AVE, SOUTH WINDSOR, CT 06074-5562
(860) 647-8282

Taxonomy

Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
134948
CT
163WP0200X
Pediatric Registered Nurse
134948
MA
363LP0200X
Pediatric Nurse Practitioner
Primary
9678
CT

Other

Enumeration date
04/28/2021
Last updated
06/09/2021
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