| Doctor Name: | DR. JILL ANNE MANDEL |
| NPI Number: | 1053565168 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | DPT |
| License Number: | 40QA01128500 |
| Business Practice Address: | 380 Washington Ave Roosevelt, NY - 115751845 |
| Business Phone Number: | 5163782000 |
| Business Fax Number: | |
| Mailing Address: | 1643 Benedict Pl, NORTH BALDWIN |
| State: | NY |
| Postal Code: | 115101712 |
| Phone Number: | 5162236442 |
| Fax Number: | |
| NPI Enumeration Date: | 11/17/2008 |
| NPI Last Update Date: | 11/17/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251P0200X |
| License Number: | 40QA01128500 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NJ |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |