Maham Mallick

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

Practice address

1651 Coney Island Ave
Brooklyn, NY 11230-5849

Phone

(718) 998-1415

NPI assigned

Jan 30, 2021

Last updated

Jan 30, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1611964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611964800000",
    "number": "1902497126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "98 RIDGE LN",
            "city": "LEVITTOWN",
            "state": "NY",
            "postal_code": "117561151",
            "telephone_number": "516-312-2329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1651 CONEY ISLAND AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112305849",
            "telephone_number": "718-998-1415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLICK",
        "first_name": "MAHAM",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-30",
        "last_updated": "2021-01-30",
        "certification_date": "2021-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keisha Karla Mallebranche, LCSW
• Laurie Herzig Mallery
• Errol Charles Mallett, MD
• George Malliaros, P.T.
• Abbas Hayat Mallick, M.D.
• Shahla Sohaib Mallick
• Mark Mallinson, L.C.S.W.
• Ariane Mallon, OTR/L
• Kristen Mallon
• Maya Danielle Mallory, LMSW

• Early Intervention Provider Agency in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Early Intervention Provider Agency in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2021; 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.