Malak Sadeq Alsaidi
Individual provider Active NPI Clinical Social Worker · Broad Channel, NY
NPI 1073392908 · NPPES record last updated Jan 15, 2026
Key facts
- NPI
- 1073392908
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 101861-01 (NY)
- Practice address
- 807 Cross Bay Blvd
Broad Channel, NY 11693-1123 - Phone
- (347) 629-0117
- NPI assigned
- Sep 28, 2023
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260520002881 | NY | Order and Referring Only - Clinical Social Worker | 1557830452 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 114975-01 | NY | MD | Social Worker |
| 101861-01 | NY | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 101861-01 | NY | Yes |
| Social Worker | 104100000X | 114975-01 | NY |
Addresses
Primary practice location
807 Cross Bay Blvd
Broad Channel, NY 11693-1123
Mailing address
807 Cross Bay Blvd
Broad Channel, NY 11693-1123
Phone (347) 629-0117
Other providers in Broad Channel, NY
All providers in Broad Channel, NY · Clinical Social Worker in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 15, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.