Active NPI
Ithamar Malave
- Registered Nurse
- Central Islip, NY
National Provider Identifier
1780935346
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 542565-1
- Practice address
- 50 Wheeler Rd
Central Islip, NY 11722-2154 - Phone
- (631) 348-5112
- NPI assigned
- Sep 24, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 542565-1 | NY | Primary |
Addresses
Primary practice location
50 Wheeler Rd
Central Islip, NY 11722-2154
Mailing address
200 E Main St
Riverhead, NY 11901-2424
Phone (631) 727-3331
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
| License | State | Type | Specialty |
|---|---|---|---|
| 542565-1 | NY | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1348444800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1348444800000",
"number": "1780935346",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 E MAIN ST",
"city": "RIVERHEAD",
"state": "NY",
"postal_code": "119012424",
"telephone_number": "631-727-3331"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "50 WHEELER RD",
"city": "CENTRAL ISLIP",
"state": "NY",
"postal_code": "117222154",
"telephone_number": "631-348-5112"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALAVE",
"first_name": "ITHAMAR",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-09-24",
"last_updated": "2012-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NY",
"license": "542565-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Central Islip, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 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.