Khadijah Muwwakkil

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

20905 Jamaica Ave
Queens Village, NY 11428-1548

Phone

(347) 542-5813

Fax

(718) 445-0951

NPI assigned

Dec 27, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Welllife Network Inc

  • Case Management Agency
  • Elmont, NY
  • NPI 1508012816
  NPD (past)
• Welllife Network Inc.

  • Case Management Agency
  • Coram, NY
  • NPI 1386817906
  NPD (past)

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

{
    "created_epoch": "1545868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545868800000",
    "number": "1417429762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14202 20TH AVE FL 3",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113513000",
            "telephone_number": "347-542-5658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20905 JAMAICA AVE",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114281548",
            "telephone_number": "347-542-5813",
            "fax_number": "718-445-0951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUWWAKKIL",
        "first_name": "KHADIJAH",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-27",
        "last_updated": "2018-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3299096",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rhenee Angelique Mullings
• Multicultural Guidance Center, Inc.
• Keith Murray
• William Gerard Murray, DDS
• Marie Lourdes Museau, LMSW
• Babak Nahavandi, DDS
• Ashamole Nair
• Jayakrishnan Nair, LMSW
• Preethy Nair, RN
• Sripriya Nair

• Student in an Organized Health Care Education/Training Program in Queens Village, NY
• Providers in Queens Village, NY by specialty
• Student in an Organized Health Care Education/Training Program in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2018; 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.