Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 223154 | NY |
N | 111NI0900X | Internist | 223154 | NY |
N | 207RG0300X | Geriatric Medicine | 223154 | NY |
NPI | 1023061272 |
---|---|
Provider Name | Dr. Deepak Mandi |
First Address | West Palm Beach, FL 33410 |
Second Address | West Palm Beach, FL 33410 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
223154 | LICENSE (01) | NY |
VAD000 | (02) |