Individual provider Active NPI

Emanuela Rose Mullokondova

  • Student in an Organized Health Care Education/Training Program
  • Rego Park, NY
National Provider Identifier
1790696672
Registry record updated Sep 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
3201579 Issued in NY
Practice address
8546 66TH Ave
Rego Park, NY 11374-5210
Phone
(917) 601-2714
NPI assigned
Sep 16, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 3201579 NY Primary

Addresses

Primary practice location

8546 66TH Ave
Rego Park, NY 11374-5210

Mailing address

8546 66TH Ave
Rego Park, NY 11374-5210

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1789516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789516800000",
    "number": "1790696672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8546 66TH AVE",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113745210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8546 66TH AVE",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113745210",
            "telephone_number": "917-601-2714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLOKONDOVA",
        "first_name": "EMANUELA",
        "middle_name": "ROSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-09-16",
        "last_updated": "2026-09-16",
        "certification_date": "2026-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": "3201579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rego Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.