Jill Anne Mandel, DPT

Primary specialty

Pediatric Physical TherapistTaxonomy code 2251P0200X

License

028109-1 Issued in NY

Practice address

380 Washington Ave
Roosevelt, NY 11575-1845

Phone

(516) 378-2000

NPI assigned

Nov 17, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1226880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226880000000",
    "number": "1053565168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1643 BENEDICT PL",
            "city": "NORTH BALDWIN",
            "state": "NY",
            "postal_code": "115101712",
            "telephone_number": "516-223-6442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 WASHINGTON AVE",
            "city": "ROOSEVELT",
            "state": "NY",
            "postal_code": "115751845",
            "telephone_number": "516-378-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDEL",
        "first_name": "JILL",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-17",
        "last_updated": "2008-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "NY",
            "license": "028109-1",
            "primary": true
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "NJ",
            "license": "40QA01128500",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Belinda Lyons
• La'Draya Shamicka Macon, LCSW, CASAC
• Monica Maria Maffetone Hladky
• Veera Malavia, D.M.D.
• Nancy Margaret Maltz, MA,CCC/SLP
• Lisa B. Maniatis-Fitting, MSN, ANP-C
• Lynn Manno
• Martino Marcello
• Juana Maria, CASAC-G
• Lisa Marquardt

• Pediatric Physical Therapist in Roosevelt, NY
• Providers in Roosevelt, NY by specialty
• Pediatric Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2008; 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.