Individual provider Active NPI

Yafit Mullukandov, SPECIAL ED

  • Specialist
  • Fresh Meadows, NY
National Provider Identifier
1396582979
Registry record updated Jul 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
1814448241 Issued in NY
Practice address
17509 Jewel Ave
Fresh Meadows, NY 11365-3427
Phone
(917) 533-5223
NPI assigned
Jul 11, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 1814448241 NY Primary

Addresses

Primary practice location

17509 Jewel Ave
Fresh Meadows, NY 11365-3427

Mailing address

17509 Jewel Ave
Fresh Meadows, NY 11365-3427
Phone (917) 533-5223

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

LicenseStateTypeSpecialty
1814448241NYMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1720656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720656000000",
    "number": "1396582979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17509 JEWEL AVE",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113653427",
            "telephone_number": "917-533-5223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17509 JEWEL AVE",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113653427",
            "telephone_number": "917-533-5223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLUKANDOV",
        "first_name": "YAFIT",
        "name_prefix": "Mrs.",
        "credential": "SPECIAL ED",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-11",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "1814448241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresh Meadows, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 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.

Verify at the official NPI Registry.