Luise Ira Mamba, CTRS

Primary specialty

Recreation TherapistTaxonomy code 225800000X

License

70325

Practice address

400 Sunrise Hwy
Amityville, NY 11701-2508

Phone

(631) 608-5433

NPI assigned

May 31, 2019

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)

Not enrolled

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

{
    "created_epoch": "1559260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559260800000",
    "number": "1851959233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 SUNRISE HWY",
            "city": "AMITYVILLE",
            "state": "NY",
            "postal_code": "117012508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 SUNRISE HWY",
            "city": "AMITYVILLE",
            "state": "NY",
            "postal_code": "117012508",
            "telephone_number": "631-608-5433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAMBA",
        "first_name": "LUISE IRA",
        "credential": "CTRS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-31",
        "last_updated": "2019-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225800000X",
            "taxonomy_group": "",
            "desc": "Recreation Therapist",
            "state": null,
            "license": "70325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael T Maiorino, D.D.S.
• Shanae Monique Maitland
• Juan E Maldonado
• Lizania Maldonado
• Kevin Malone, PHARM D.
• Alyssa M Mancuso
• Jaime L Mangan, M.A. CCC-SLP
• Neel Mann, MD
• Shonda Mann, L.P.N.
• Dina Marie Marabello-Palma, ATR-BC, LCAT

• Recreation Therapist in Amityville, NY
• Providers in Amityville, NY by specialty
• Recreation Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2019; 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.