Provider Demographics
NPI:1669600243
Name:MAHLUNGE MUMANYI, HAATSARI R (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:HAATSARI
Middle Name:R
Last Name:MAHLUNGE MUMANYI
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MISS
Other - First Name:HAATSARI
Other - Middle Name:R
Other - Last Name:MAHLUNGE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:38 HELEN DR
Mailing Address - Street 2:
Mailing Address - City:WAPPINGERS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12590-1715
Mailing Address - Country:US
Mailing Address - Phone:845-297-5245
Mailing Address - Fax:845-297-5245
Practice Address - Street 1:38 HELEN DR
Practice Address - Street 2:
Practice Address - City:WAPPINGERS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12590-1715
Practice Address - Country:US
Practice Address - Phone:845-297-5245
Practice Address - Fax:845-297-5245
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-23
Last Update Date:2009-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009257171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor