Basic Information
| Provider Information | |||||||||
| NPI: | 1558340638 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MANDELKER | ||||||||
| FirstName: | EIRAN | ||||||||
| MiddleName: | MOSES | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2775 SCHOENERSVILLE RD | ||||||||
| Address2: | |||||||||
| City: | BETHLEHEM | ||||||||
| State: | PA | ||||||||
| PostalCode: | 180177307 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6108618080 | ||||||||
| FaxNumber: | 6108070366 | ||||||||
| Practice Location | |||||||||
| Address1: | 2775 SCHOENERSVILLE RD | ||||||||
| Address2: | |||||||||
| City: | BETHLEHEM | ||||||||
| State: | PA | ||||||||
| PostalCode: | 180177307 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6108618080 | ||||||||
| FaxNumber: | 6108070366 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/17/2006 | ||||||||
| LastUpdateDate: | 01/07/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | MD427856 | PA | Y | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
ID Information
| ID | Type | State | Issuer | Description | 3170553 | 01 | MAMSI | OTHER | P00277600 | 01 | RAILROAD MEDICARE | OTHER | 100922 | 01 | GEISINGER HEALTH PLAN | OTHER | 2621413000 | 01 | AMERIHEALTH | OTHER | 2621413000 | 01 | INDEPENDENCE BLUE CROSS | OTHER | 2621413000 | 01 | KEYSTONE HEALTH EAST | OTHER | 50067839 | 01 | KEYSTONE HEALTH CENTRAL | OTHER | P3687147 | 01 | OXFORD HEALTH PLANS | OTHER | 1784134 | 01 | HIGHMARK BLUE SHIELD | OTHER | 5358321 | 01 | CIGNA HEALTHCARE | OTHER | 9411306 | 01 | PRIVATE HEALTHCARE SYSTEM | OTHER | 1189550 | 01 | AETNA HMO | OTHER | 1845942 | 01 | UNITED HEALTHCARE | OTHER | 50067839 | 01 | CAPITAL BLUE CROSS | OTHER | 5466687 | 01 | AETNA PPO | OTHER |