Mamba, Luise Ira

Mamba, Luise Ira is an individual health care provider with primary practice located at 400 Sunrise Hwy , Amityville NY 11701-2508. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Recreation Therapist, which is considered as her primary health care specialty. Mamba, Luise Ira can be contacted via phone (631) 608-5433.

Contact Information

Primary practice address
400 Sunrise Hwy Amityville NY 11701-2508
Phone: (631) 608-5433
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Recreation Therapist 225800000X 70325

Profile Details

NPI number 1851959233
LBN Legal business name Mamba, Luise Ira
Credentials CTRS
Entity Individual
Sole proprietor 1 No
Enumeration date May 31st, 2019
Last updated May 31st, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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