Larisa Mullodzhanova, M.S., OTR/L

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

016063 Issued in NY

Practice address

9705 Horace Harding Expy Apt 11B
Corona, NY 11368-4104

Phone

(718) 791-2594

NPI assigned

Feb 12, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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

{
    "created_epoch": "1297468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297468800000",
    "number": "1255638169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9705 HORACE HARDING EXPY APT 11B",
            "city": "CORONA",
            "state": "NY",
            "postal_code": "113684104",
            "telephone_number": "718-791-2594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9705 HORACE HARDING EXPY APT 11B",
            "city": "CORONA",
            "state": "NY",
            "postal_code": "113684104",
            "telephone_number": "718-791-2594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLODZHANOVA",
        "first_name": "LARISA",
        "name_prefix": "Ms.",
        "credential": "M.S., OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-02-12",
        "last_updated": "2011-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NY",
            "license": "016063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacy Moyston
• Mujtaba NP in Family Health, P.C.
• Mujtaba Women's Health Midwifery PC
• Athar Mujtaba, NP
• Ayesha Mujtaba, ARNP, CNM
• Mazal Mullodzhanova
• Violetta Munarova, PHARMD
• Shikha Patel Muni, DO
• Jeysiyareth Mariana Munoz-Abarca
• Artur Albertovich Mushyakov, MD

• Pediatric Occupational Therapist in Corona, NY
• Providers in Corona, NY by specialty
• Pediatric Occupational Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2011; 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.