Nbba Malik

Primary specialty

OptometristTaxonomy code 152W00000X

License

TUV009238 Issued in NY

Practice address

1401 Veterans Pkwy
Suite 1100
Clarksville, IN 47129-8724

Phone

(812) 704-5521

NPI assigned

Jun 16, 2015

Last updated

Feb 10, 2021By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1434412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612915200000",
    "number": "1720469620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 HANOVER SQ",
            "address_2": "APT 17Q",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100053569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 VETERANS PKWY",
            "address_2": "SUITE 1100",
            "city": "CLARKSVILLE",
            "state": "IN",
            "postal_code": "471298724",
            "telephone_number": "812-704-5521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALIK",
        "first_name": "NBBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-16",
        "last_updated": "2021-02-10",
        "certification_date": "2021-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV009238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Crystal S Mack, RBT
• Nancy Jeanne Mackenzie III
• Madelyn Mackey, RBT
• Julia Madej, RD
• Mainstream Transportation Authority,Inc.
• Ryan N Malone, RBT
• Savannah Mancine
• Audrey Manis, MT-BC
• Maple Grove Mental Health LLC
• Abigail Marks

• Optometrist in Clarksville, IN
• Providers in Clarksville, IN by specialty
• Optometrist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2021; 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.