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Individual

DR. JEREMY JOEL MANDIA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
300 W HOSPITAL RD BLDG 319, FORT EISENHOWER, GA 30905-5741
(845) 702-7358
Mailing address
300 W HOSPITAL RD BLDG 319, FORT EISENHOWER, GA 30905-5741
(706) 787-1190

Taxonomy

Speciality
Code
Description
License number
State
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
Primary
279197
NY
208D00000X
General Practice Physician
279197
NY

Other

Enumeration date
06/17/2013
Last updated
01/30/2025
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