Individual
DR. ROBERT MANDULEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
125 PATERSON STREET, SUITE 6140 CAB, NEW BRUNSWICK, NJ 08901
(732) 235-7905
Mailing address
66 WEST GILBERT ST, RED BANK, NY 07701
(732) 212-0051
(732) 212-0713
Taxonomy
Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
179409
NY
2080P0202X
Pediatric Cardiology Physician
Primary
25MA05979700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01550678
—
NY
01
—
25MA05979700
NJ LICENSE
NJ
05
—
6238700
—
NJ
Enumeration date
01/11/2006
Last updated
07/23/2021
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