Individual
SUSAN J MANDEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3400 CIVIC CENTER BOULEVARD, WEST PAVILION, 4TH FLOOR, PHILADELPHIA, PA 19104-5134
(215) 662-2300
(215) 614-0418
Mailing address
3400 CIVIC CENTER BOULEVARD, WEST PAVILION, 4TH FLOOR, PHILADELPHIA, PA 19104-5134
(215) 662-2300
(215) 614-0418
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
MD062785L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0016521760003
—
PA
Enumeration date
06/27/2006
Last updated
06/21/2012
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