Individual
MORDECHAI MANDELBAUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1239 46TH ST, BROOKLYN, NY 11219-2027
(917) 825-6777
Mailing address
PO BOX 190084, BROOKLYN, NY 11219-0084
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1466
LTC
—
Enumeration date
11/30/2022
Last updated
12/14/2022
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