Basic Information
| Provider Information | |||||||||
| NPI: | 1003058769 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TORABI | ||||||||
| FirstName: | MANDANA | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1090 AMSTERDAM AVENUE | ||||||||
| Address2: | ST. LUKE'S ROOSEVELT HOSPITAL 17TH FLOOR | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100250000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2125235194 | ||||||||
| FaxNumber: | 2125233642 | ||||||||
| Practice Location | |||||||||
| Address1: | 5151 MONROE ST STE 200 | ||||||||
| Address2: | |||||||||
| City: | TOLEDO | ||||||||
| State: | OH | ||||||||
| PostalCode: | 436233466 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4194754449 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/27/2009 | ||||||||
| LastUpdateDate: | 03/17/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | 35.132089 | OH | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
ID Information
| ID | Type | State | Issuer | Description | 267851 | 01 | NY | NY STATE LICENSE NUMBER | OTHER | 35.132089 | 01 | OH | OHIO MD LICENSE | OTHER |