Individual provider Active NPI

Malka Wisebrod

  • Registered Nurse
  • Flushing, NY
National Provider Identifier
1033056189
Registry record updated Apr 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
993702 Issued in NY
Practice address
14114 72ND Dr BSMT
Flushing, NY 11367-2313
Phone
(845) 558-9725
NPI assigned
Apr 29, 2026
Last updated
Apr 29, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 993702 NY Primary

Addresses

Primary practice location

14114 72ND Dr BSMT
Flushing, NY 11367-2313

Mailing address

14114 72ND Dr BSMT
Flushing, NY 11367-2313

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
993702NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1777420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777420800000",
    "number": "1033056189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14114 72ND DR BSMT",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113672313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14114 72ND DR BSMT",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113672313",
            "telephone_number": "845-558-9725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISEBROD",
        "first_name": "MALKA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-04-29",
        "last_updated": "2026-04-29",
        "certification_date": "2026-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "993702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2026; 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.