NPIMap

Organization Active NPI

Kumar S Mandal MD PC

  • Family Medicine Physician
  • Shirley, NY
National Provider Identifier
1497924476
Registry record updated Jun 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
KUMAR S MANDAL MD PC
Practice address
2 Coraci Blvd
Shirley, NY 11967-4833
Phone
(631) 281-2600
Fax
(631) 281-6732
NPI assigned
Feb 25, 2008
Last updated
Jun 3, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kumar S Mandal, MDNPI 1689676884
Title
MD
Phone
(631) 281-2600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

2 Coraci Blvd
Shirley, NY 11967-4833

Mailing address

2 Coraci Blvd
Shirley, NY 11967-4833
Phone (631) 281-2600

National Provider Directory

National Provider Directory

Locations

2 Coraci Blvd
Shirley, NY 11967
Phone (631) 281-4861

2 Coraci Blvd
Ste 10
Shirley, NY 11967
Phone (631) 281-2600

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1203897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433289600000",
    "number": "1497924476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 CORACI BLVD",
            "city": "SHIRLEY",
            "state": "NY",
            "postal_code": "119674833",
            "telephone_number": "631-281-2600",
            "fax_number": "631-281-6732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 CORACI BLVD",
            "city": "SHIRLEY",
            "state": "NY",
            "postal_code": "119674833",
            "telephone_number": "631-281-2600",
            "fax_number": "631-281-6732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KUMAR S MANDAL MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-25",
        "last_updated": "2015-06-03",
        "status": "A",
        "authorized_official_last_name": "MANDAL",
        "authorized_official_first_name": "KUMAR",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "631-281-2600",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shirley, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.