Amanda Dawn Mizel

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

017511-1 Issued in NY

Practice address

25 Pine St
Freeport, NY 11520-3617

Phone

(516) 867-5280

NPI assigned

Oct 21, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Outreach Physical and Occupational Therapy & Speech Rehabilitation, PLLC

  • Physical Therapist
  • Great Neck, NY
  • NPI 1841526399

  Speech-Language Pathologist

  NPD (past)

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

{
    "created_epoch": "1256083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335830400000",
    "number": "1184950453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "837 BECKMAN DR",
            "city": "NORTH BELLMORE",
            "state": "NY",
            "postal_code": "117101342",
            "telephone_number": "516-236-2495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 PINE ST",
            "city": "FREEPORT",
            "state": "NY",
            "postal_code": "115203617",
            "telephone_number": "516-867-5280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIZEL",
        "first_name": "AMANDA",
        "middle_name": "DAWN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-21",
        "last_updated": "2012-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "017511-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Jaclyn Mirabile, LCSW
• Jordan Mittelmark
• Afeisha Kizzyann Modeste Holsey
• Momentum Chiropractic, PC
• Patricia Mompoint, PA
• Catherine Moore, R.N.
• Wendy Moreta

• Speech-Language Pathologist in Freeport, NY
• Providers in Freeport, NY by specialty
• Speech-Language Pathologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2012; 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.