Individual provider Active NPI

Wajeha Khalil-Abdullah, R.N.

  • Registered Nurse
  • Staten Island, NY
National Provider Identifier
1770733230
Registry record updated Jan 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
652330 Issued in NY
Practice address
442 Van Name Ave
Staten Island, NY 10303-2123
Phone
(718) 360-3383
NPI assigned
Sep 22, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 652330 NY Primary
Licensed Practical Nurse 164W00000X 290747 NY

Addresses

Primary practice location

442 Van Name Ave
Staten Island, NY 10303-2123

Mailing address

442 Van Name Ave
Staten Island, NY 10303-2123
Phone (718) 360-3383

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
652330NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1222041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325548800000",
    "number": "1770733230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "442 VAN NAME AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103032123",
            "telephone_number": "718-360-3383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "442 VAN NAME AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103032123",
            "telephone_number": "718-360-3383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHALIL-ABDULLAH",
        "first_name": "WAJEHA",
        "credential": "R.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-22",
        "last_updated": "2012-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "652330",
            "primary": true
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "290747",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 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.