Provider Demographics
NPI:1922241587
Name:MANDELL, JULIE (MS, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:
Last Name:MANDELL
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 1:15 OXBOW CT
Mailing Address - Street 2:
Mailing Address - City:EAST NORTHPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11731-3833
Mailing Address - Country:US
Mailing Address - Phone:646-262-4123
Mailing Address - Fax:
Practice Address - Street 1:34 PLAZA ST E
Practice Address - Street 2:SUITE #704
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11238-5038
Practice Address - Country:US
Practice Address - Phone:646-262-4123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-13
Last Update Date:2009-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009858-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist