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Contact Information

STACI A MANDROLA, MD
7504 WESTPORT RD
LOUISVILLE, KY40222-4108
 Phone: 502-693-2681
 Fax: 502-456-9738
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Hospice and Palliative Medicine

207RH0002X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for STACI A MANDROLA · (Female)

NPI Number 1912129552
Status Active
Credentials MD
Entity Individual
Enumeration date 05/03/2007
Last updated 01/11/2013 - About 13 years ago
Sole proprietor 1 No
Identifiers
  • KY License # 41139
  • KY Medicaid 7100094260
  • KY Other 000000642419 ANTHEM
  • KY Other 50026942 PASSPORT
  • KY Other 3756448000 PASSPORT ADVANTAGE
Hospital affiliation(s) Not Available
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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