Individual provider Active NPI

Safiyyah Aminah Abdul-Qawiyy, RN,BSN,LP

  • Health Service Psychologist
  • Staten Island, NY
National Provider Identifier
1225303654
Registry record updated Mar 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service PsychologistTaxonomy code 103TH0100X
License
505910 Issued in NY
Practice address
140 Cebra Ave
Staten Island, NY 10304-2224
Phone
(347) 628-3467
NPI assigned
Mar 19, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 19, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Psychologist 103TH0100X 505910 NY Primary

Addresses

Primary practice location

140 Cebra Ave
Staten Island, NY 10304-2224

Mailing address

140 Cebra Avenue
Staten Island, NY 10304
Phone (347) 628-3467

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
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
505910NYMDHealth Service Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1332115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332115200000",
    "number": "1225303654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 CEBRA AVENUE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10304",
            "telephone_number": "347-628-3467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 CEBRA AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103042224",
            "telephone_number": "347-628-3467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABDUL-QAWIYY",
        "first_name": "SAFIYYAH",
        "middle_name": "AMINAH",
        "name_prefix": "Ms.",
        "credential": "RN,BSN,LP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-19",
        "last_updated": "2012-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "NY",
            "license": "505910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2012; 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.