Active NPI
Imanuel Murdakhayev, OTR/L
- Occupational Therapist
- Rego Park, NY
National Provider Identifier
1306082912
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 016977
- Practice address
- 6411 99TH St
Apt. 308
Rego Park, NY 11374-2654 - Phone
- (347) 649-1982
- NPI assigned
- Jan 2, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 016977 | NY | Primary |
Addresses
Primary practice location
6411 99TH St
Apt. 308
Rego Park, NY 11374-2654
Mailing address
6411 99TH St
Apt. 308
Rego Park, NY 11374-2654
Phone (347) 649-1982
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
| License | State | Type | Specialty |
|---|---|---|---|
| 016977 | NY | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1230854400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1331856000000",
"number": "1306082912",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6411 99TH ST",
"address_2": "APT. 308",
"city": "REGO PARK",
"state": "NY",
"postal_code": "113742654",
"telephone_number": "347-649-1982"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6411 99TH ST",
"address_2": "APT. 308",
"city": "REGO PARK",
"state": "NY",
"postal_code": "113742654",
"telephone_number": "347-649-1982"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MURDAKHAYEV",
"first_name": "IMANUEL",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-01-02",
"last_updated": "2012-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "016977",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rego Park, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 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.