1740364272 NPI number — DR. HOWARD RICHARD MANGEL ED.D.

Table of content: DR. HOWARD RICHARD MANGEL ED.D. (NPI 1740364272)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740364272 NPI number — DR. HOWARD RICHARD MANGEL ED.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MANGEL
Provider First Name:
HOWARD
Provider Middle Name:
RICHARD
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
ED.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1740364272
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/09/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 805
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BELLE MEAD
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08502-0805
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
908-864-7180
Provider Business Mailing Address Fax Number:
908-369-0557

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1323 HWY 27
Provider Second Line Business Practice Location Address:
SUITE 1F
Provider Business Practice Location Address City Name:
SOMERSET
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08873-3457
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
908-864-7180
Provider Business Practice Location Address Fax Number:
908-369-0557
Provider Enumeration Date:
10/24/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103G00000X , with the licence number:  35SI00256900 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 030751000 . This is a "MAGELLAN HEALTH" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 051487 . This is a "VALUE OPTIONS" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".




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