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Individual

DR. GRACE KIM MANDIGO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
710 W 168TH ST FL 4, NEUROLOGICAL INSTITUTE, DEPARTMENT OF NEUROSURGERY, NEW YORK, NY 10032-3726
(212) 305-8101
Mailing address
300 E 77TH ST APT 6A, NEW YORK, NY 10075-2451

Taxonomy

Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
246538-1
NY

Other

Enumeration date
11/04/2008
Last updated
01/15/2010
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