Mama Program LLC

Primary specialty

Local Education Agency (LEA)Taxonomy code 251300000X

Legal business name

MAMA PROGRAM LLC

Practice address

11821 Queens Blvd Ste 415
Forest Hills, NY 11375-7208

Phone

(917) 749-2068

Fax

(718) 989-3829

NPI assigned

Jan 11, 2011

Organization subpart

No

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

Authorized official

Name

Mr. Anatoliy Benyaminov

Title

Ceo

Phone

(917) 749-2068

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1294704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294704000000",
    "number": "1841595527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11821 QUEENS BLVD STE 415",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113757208",
            "telephone_number": "917-749-2068",
            "fax_number": "718-989-3829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11821 QUEENS BLVD STE 415",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113757208",
            "telephone_number": "917-749-2068",
            "fax_number": "718-989-3829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAMA PROGRAM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-11",
        "last_updated": "2011-01-11",
        "status": "A",
        "authorized_official_last_name": "BENYAMINOV",
        "authorized_official_first_name": "ANATOLIY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "917-749-2068",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251300000X",
            "taxonomy_group": "",
            "desc": "Local Education Agency (LEA)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Upkar S Malla, PHARM D
• Missthomas L Mallord
• Lisa Malmstrom
• Anando Kumar Malo, MD
• Cassandra Theresa Malouta, MA
• Michelle Mamann
• Vyacheslav Mamanov, NP
• Mitchell Mamorsky, D.M.D
• Gisela Mamposo, LCSW-R
• Shreya Mandal, JD LCSW

• Local Education Agency (LEA) in Forest Hills, NY
• Providers in Forest Hills, NY by specialty
• Local Education Agency (LEA) in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2011; 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.