Doctor Name: | CLEMENS A MANDEL |
NPI Number: | 1114008240 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | 139190 |
Business Practice Address: | 8375 Woodhaven Blvd Woodhaven, NY - 114211535 |
Business Phone Number: | 7188495012 |
Business Fax Number: | 7188052422 |
Mailing Address: | 8375 Woodhaven Blvd, WOODHAVEN |
State: | NY |
Postal Code: | 114211535 |
Phone Number: | 7188495012 |
Fax Number: | 7188052422 |
NPI Enumeration Date: | 10/17/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2080A0000X |
License Number: | 139190 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Pediatrics |
Taxonomy Specialization: | Adolescent Medicine |
Taxonomy Definition: | A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |