Doctor Name: | JOSEPH MANDELBAUM |
NPI Number: | 1467510149 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | CCC-A, CNIM |
License Number: | 1164 |
Business Practice Address: | 1086 Teaneck Rd Ste 4a Teaneck, NJ - 076664858 |
Business Phone Number: | 2018629900 |
Business Fax Number: | 2018629136 |
Mailing Address: | 1086 Teaneck Rd Ste 4a, TEANECK |
State: | NJ |
Postal Code: | 076664858 |
Phone Number: | 2018629900 |
Fax Number: | 2018629136 |
NPI Enumeration Date: | 12/05/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 1164 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | NY |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |