Individual provider Active NPI

Rachia Yakubu

  • Registered Nurse
  • Centereach, NY
National Provider Identifier
1902109440
Registry record updated Dec 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
620634 Issued in NY
Practice address
94 Hawkins Rd
Centereach, NY 11720-1802
Phone
(571) 201-9948
NPI assigned
Dec 6, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 620634 NY Primary

Addresses

Primary practice location

94 Hawkins Rd
Centereach, NY 11720-1802

Mailing address

94 Hawkins Rd
Centereach, NY 11720-1802
Phone (571) 201-9948

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

LicenseStateTypeSpecialty
620634NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1291593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291593600000",
    "number": "1902109440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "94 HAWKINS RD",
            "city": "CENTEREACH",
            "state": "NY",
            "postal_code": "117201802",
            "telephone_number": "571-201-9948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94 HAWKINS RD",
            "city": "CENTEREACH",
            "state": "NY",
            "postal_code": "117201802",
            "telephone_number": "571-201-9948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAKUBU",
        "first_name": "RACHIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-06",
        "last_updated": "2010-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "620634",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centereach, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2010; 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.