Provider Demographics
NPI:1003068388
Name:MANGELS, LYNDA BETH (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:LYNDA
Middle Name:BETH
Last Name:MANGELS
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 ABBEY LN
Mailing Address - Street 2:
Mailing Address - City:LEVITTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11756-4009
Mailing Address - Country:US
Mailing Address - Phone:917-620-3463
Mailing Address - Fax:
Practice Address - Street 1:70 ABBEY LN
Practice Address - Street 2:
Practice Address - City:LEVITTOWN
Practice Address - State:NY
Practice Address - Zip Code:11756-4009
Practice Address - Country:US
Practice Address - Phone:917-620-3463
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-16
Last Update Date:2012-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018610235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist