Individual
DR. KUMAR S MANDAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2 CORACI BLVD, STE 10, SHIRLEY, NY 11967-4833
(631) 281-2600
(631) 281-6732
Mailing address
2 CORACI BLVD, STE 10, SHIRLEY, NY 11967-4833
(631) 281-2600
(631) 281-6732
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
182787
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01519864
—
NY
Enumeration date
06/01/2005
Last updated
06/02/2015
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