Nelly Amanda Mardiros

Primary specialty

Rehabilitation PractitionerTaxonomy code 225400000X

Practice address

14515 Hamlin St Ste 102
Van Nuys, CA 91411-1694

Phone

(818) 989-7475

Fax

(844) 623-5985

NPI assigned

Apr 19, 2019

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)

Not enrolled

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

{
    "created_epoch": "1555632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629158400000",
    "number": "1336702844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14515 HAMLIN ST STE 102",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914111694",
            "telephone_number": "818-989-7475",
            "fax_number": "844-623-5985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14515 HAMLIN ST STE 102",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914111694",
            "telephone_number": "818-989-7475",
            "fax_number": "844-623-5985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARDIROS",
        "first_name": "NELLY",
        "middle_name": "AMANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-19",
        "last_updated": "2021-08-17",
        "certification_date": "2021-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Remo Marayag
• Dora Joy Marcinkowski, CMT
• Taryn Raine Marcos
• Lunye M Marcus
• Karen Marder, CATC III
• Astghik Margaryan, FNP
• Daniel Margolies, PA
• Rosmeri Marin Guerrero, PSY.D.
• Darby Johanna Marin, SLPA
• Maritza Marin

• Rehabilitation Practitioner in Van Nuys, CA
• Providers in Van Nuys, CA by specialty
• Rehabilitation Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2021; 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.