Individual provider Active NPI

Elena Mullokandov, MA. ED

  • Early Intervention Provider Agency
  • Brooklyn, NY
National Provider Identifier
1669739223
Registry record updated Apr 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
License
1390708 Issued in NY
Practice address
2625 E 14TH St Ste 200
Brooklyn, NY 11235-3973
Phone
(718) 769-2698
NPI assigned
Apr 19, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 19, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X 1390708 NY Primary

Addresses

Primary practice location

2625 E 14TH St Ste 200
Brooklyn, NY 11235-3973

Mailing address

9947 62ND Rd FL 2
Rego Park, NY 11374-1474
Phone (347) 499-2550

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
1390708NYMDEarly Intervention Provider Agency

NPI Registry JSON

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

{
    "created_epoch": "1334793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334793600000",
    "number": "1669739223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9947 62ND RD FL 2",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113741474",
            "telephone_number": "347-499-2550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2625 E 14TH ST STE 200",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112353973",
            "telephone_number": "718-769-2698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLOKANDOV",
        "first_name": "ELENA",
        "name_prefix": "Mrs.",
        "credential": "MA. ED",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-19",
        "last_updated": "2012-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "NY",
            "license": "1390708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 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.

Verify at the official NPI Registry.