Individual
DR. CHARISSE LAURA MANDIMIKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
15 YORK ST, NEW HAVEN, CT 06510-3221
(203) 688-5303
(203) 688-3216
Mailing address
1450 CHAPEL ST # PRIVATE3, NEW HAVEN, CT 06511-4405
(203) 789-4044
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/03/2014
Last updated
06/06/2015
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