Luna G Mandal

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

10117 Issued in NC

Practice address

733 Plantation Estates Dr
Matthews, NC 28105-9116

Phone

(704) 815-0371

NPI assigned

Sep 1, 2009

Sex

Female

Sole proprietor

Yes

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

State licenses

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

{
    "created_epoch": "1251763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356048000000",
    "number": "1902039316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4845 ASHLEY PARK LN",
            "address_2": "#200",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282103334",
            "telephone_number": "847-707-1034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "733 PLANTATION ESTATES DR",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281059116",
            "telephone_number": "704-815-0371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDAL",
        "first_name": "LUNA",
        "middle_name": "G",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-01",
        "last_updated": "2012-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "10117",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.005645",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gangadhar Rao Malasana, MD
• David Paul Malone, M.D.
• Meghan Elise Maloney, PT
• Victoria L Malz, DMD
• Leah Joy Mancini, LCMHC-A
• Christian Copeland Maness, RN
• Manna Audiology and Hearing Aid
• Robert Manning, FNP-C
• George Anthony Manousos, MD
• Renee Marcoux

• Speech-Language Pathologist in Matthews, NC
• Providers in Matthews, NC by specialty
• Speech-Language Pathologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 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.