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Contact Information

KUMAR S MANDAL, MD
2 CORACI BLVD
STE 10
SHIRLEY, NY11967-4833
 Phone: 631-281-2600
 Fax: 631-281-6732
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Adult Medicine

207QA0505X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for KUMAR S MANDAL · (Male)

NPI Number 1689676884
Status Active
Credentials MD
Entity Individual
Enumeration date 06/01/2005
Last updated 06/02/2015 - About 11 years ago
Sole proprietor 1 Yes
Identifiers
  • NY License # 182787
  • NY Medicaid 01519864
Hospital affiliation(s)
  • BROOKHAVEN MEMORIAL HOSPITAL MEDICAL CENTER - (Acute Care)
    101 HOSPITAL ROAD
    PATCHOGUE, NY 11772
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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