Active NPI
Alia Beatrice Danielle Mostafa, APRN
- Nurse Practitioner
- Trumbull, CT
National Provider Identifier
1346063765
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 14102
- Practice address
- 10 Broadway
Trumbull, CT 06611-1367 - Phone
- (203) 923-3147
- NPI assigned
- Nov 4, 2024
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 14102 | CT | Primary |
Addresses
Primary practice location
10 Broadway
Trumbull, CT 06611-1367
Mailing address
59 Carriage Dr
Milford, CT 06460-7556
Phone (203) 923-3147
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 |
|---|---|---|---|
| 14102 | CT | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1730678400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730678400000",
"number": "1346063765",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "59 CARRIAGE DR",
"city": "MILFORD",
"state": "CT",
"postal_code": "064607556",
"telephone_number": "203-923-3147"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 BROADWAY",
"city": "TRUMBULL",
"state": "CT",
"postal_code": "066111367",
"telephone_number": "203-923-3147"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOSTAFA",
"first_name": "ALIA",
"middle_name": "BEATRICE DANIELLE",
"credential": "APRN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-11-04",
"last_updated": "2024-11-04",
"certification_date": "2024-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner",
"state": "CT",
"license": "14102",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Trumbull, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.