DR. KUMAR S MANDAL (NPI# 1689676884) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1689676884 |
Entity Type | Individual |
Full Name | DR. KUMAR S MANDAL |
Credential | M.D. |
Practice Address |
2 Coraci Blvd Ste 10 Shirley NY 11967-4833 |
Practice Telephone | 6312812600 |
Practice Fax Number | 6312816732 |
Mailing Telephone | 6312812600 |
Mailing Fax Number | 6312816732 |
Enumeration Date | 2005-06-01 |
Last Update Date | 2015-06-02 |
NPI Deactivation Date | 03/20/2006 |
NPI Reactivation Date | 2006-03-27 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207QA0505X |
Family Medicine Specialization: Adult Medicine |
182787 | NY | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NY | 01519864 | 05 |
Street Address |
2 CORACI BLVD STE 10 |
City | SHIRLEY |
State | NY |
Zip Code | 11967-4833 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1255650685 | Neeru Kumar | Internal Medicine | 2 Coraci Blvd, Ste 11, Shirley, NY 11967-4833 | 2010-05-25 |
1447581723 | Christopher Horsford Pt PC | Physical Therapist | 2 Coraci Blvd, Suite 2, Shirley, NY 11967-4833 | 2010-01-26 |
1689902702 | Martha Ann Taylor | Massage Therapist | 2 Coraci Blvd, Suite 5, Shirley, NY 11967-4833 | 2009-12-01 |
1659609949 | Gregory R Groth | Massage Therapist | 2 Coraci Blvd, Suite 5, Shirley, NY 11967-4833 | 2009-11-24 |
1003072356 | Philip J. Makowski, Md, Pllc | Exclusive Provider Organization | 2 Coraci Blvd, Suite 17, Shirley, NY 11967-4833 | 2008-08-05 |
1619132925 | Lisa M Kayser | Physician Assistant | 2 Coraci Blvd, Suite 10, Shirley, NY 11967-4833 | 2008-07-25 |
1518126788 | Atul N. Shah, Md, PC | Clinic/Center | 2 Coraci Blvd, Suite 13 & 14, Shirley, NY 11967-4833 | 2008-06-03 |
1306005699 | Anthony Tomasso, Do Pllc | Family Medicine | 2 Coraci Blvd, Ste #4, Shirley, NY 11967-4833 | 2008-06-03 |
1497924476 | Kumar S Mandal Md PC | Family Medicine | 2 Coraci Blvd, Shirley, NY 11967-4833 | 2008-02-25 |
1720260870 | Shirley Chiropractic Ctr. | Chiropractor | 2 Coraci Blvd, Suite 3, Shirley, NY 11967-4833 | 2007-11-30 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1588149744 | Dawn Kirby | Licensed Practical Nurse | 8 Crestwood Drive, Shirley, NY 11967 | 2018-10-03 |
1538684451 | Crystal E Gambles | Licensed Practical Nurse | 502 Wellwood Drive, Shirley, NY 11967 | 2017-08-11 |
1003330887 | Aura Blum Care, Inc | Licensed Practical Nurse | 436 Auborn Av, Shirley, NY 11967 | 2017-08-02 |
1891239687 | Holly Scott-rodriguez | Behavior Technician | 57 Probst Drive, Shirley, NY 11967 | 2016-12-13 |
1487106357 | Joann C Duran | Licensed Practical Nurse | 320 Decatur Avenue, East Yaphank, NY 11967 | 2016-10-26 |
1053776815 | Andrea Janet Murphy-hamilton | Registered Nurse | 369 Puritan Dr., N Shirley, NY 11967 | 2015-12-22 |
1588039598 | Thomas B Maher | Student in an Organized Health Care Education/Training Program | 483 West End Ave., Shirley, NY 11967 | 2015-12-02 |
1346676707 | Sharon Marie Dougherty | Social Worker | 1250 William Floyd Parkway, Shirley, NY 11967 | 2013-09-17 |
1083964241 | Charlotte Dametra Fleming | Licensed Practical Nurse | 420 Lakepointe Drive, Middleisland, NY 11967 | 2012-09-14 |
1982954277 | Sefika Dimaggio | Registered Nurse | 32 Candido Ave, Shirley, NY 11967 | 2012-09-13 |
Find all providers in zip 11967 |
Taxonomy Code | 207QA0505X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Family Medicine |
Specialization | Adult Medicine |
Definition to come. |
NPI | Name | Taxonomy | Address | Enumeration |
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1982202073 | Stella Macharia | Family Medicine | 100 Harvard Rd, Shirley, MA 01464 | 2020-10-12 |
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1083220677 | Ellen Mcstravick | Family Medicine | 5530 Sheridan Dr Ste 2, Williamsville, NY 14221-3730 | 2020-09-18 |
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1871145011 | Prince Aboagye Dankwah | Family Medicine | 157 Barnes Rd, Washingtonville, NY 10992-1931 | 2019-07-09 |
1194206441 | Madison Physician Practice PC | Family Medicine | 983 Park Ave # 1d, New York, NY 10028-0808 | 2018-08-24 |
1245717115 | Darlean James | Family Medicine | 183 Park St Ste 5678, Malone, NY 12953 | 2018-07-24 |
1609380617 | Donna Yu | Family Medicine | 6402 8th Ave Ste 301, Brooklyn, NY 11220-4720 | 2017-11-29 |
1720591688 | Jane S Ferraina | Family Medicine | 259 Boughton Hill Rd, Honeoye Falls, NY 14472-9706 | 2017-11-14 |
1245750918 | Long Island Nurse Practitioners | Family Medicine | 97 Ronni Dr, East Meadow, NY 11554-1330 | 2017-06-23 |
1548700925 | Special Medical PC | Family Medicine | 699 B Stanley Avenue, Brooklyn, NY 11207 | 2017-03-03 |
1043762404 | Ji Medical Group PC | Family Medicine | 3825 Parsons Blvd, Ste 1g, Flushing, NY 11354-5837 | 2016-11-01 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.