MUJTABA NP IN FAMILY HEALTH, P.C.
NPI 1639765704
Nurse Practitioner - Family in Corona, NY

Q: What is Mujtaba Np In Family Health, P.C.'s NPI number?

The NPI number for Mujtaba Np In Family Health, P.C. is 1639765704. It was assigned to this organization in the NPPES registry on December 14, 2020.

Q: What is Mujtaba Np In Family Health, P.C.'s specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Active since December 14, 2020CLIA 33D2173160 · Waiver

10426 ROOSEVELT AVE, CORONA, NY 11368(718) 533-0991(833) 969-0190 Get Directions Write a Review

NPPES record last updated: December 22, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Dec 22, 2020, Dec 14, 2020 (2 updates tracked since 2020).

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About Mujtaba Np In Family Health, P.c. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MUJTABA NP IN FAMILY HEALTH, P.C. (NPI 1639765704) is a healthcare organization registered as a family in Corona, New York and active in the NPI registry since December 2020. The organization holds a CLIA Waiver certificate valid through October 6, 2027 and lists Athar Mujtaba, Ceo/provider, as its authorized official.

NPPES Registry Identity

NPI1639765704

Entity TypeOrganization

Primary Taxonomy363LF0000X

Legal Business NameMUJTABA NP IN FAMILY HEALTH, P.C.

Location Address10426 ROOSEVELT AVECorona, NY 11368-2328

Mailing Address10426 Roosevelt AveCorona, NY 11368-2328 · (917) 982-5007

Phone(718) 533-0991

Fax(833) 969-0190

Organization SubpartNo

Authorized OfficialAthar MujtabaCeo/provider · (917) 982-5007

Enumeration DateDecember 14, 2020

Last NPPES UpdateDecember 22, 20202 updates tracked since enumeration

NPPES CertifiedDecember 22, 2020

✔ NPI 1639765704 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

10426 ROOSEVELT AVE, Corona, NY 11368

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 33D2173160

Mujtaba Np In Family Health PC · Corona, NY

Active · expires Oct 6, 2027

CLIA Number33D2173160

Laboratory TypePhysician Office

Certificate Effective DateOctober 7, 2025

Certificate Expiration DateOctober 6, 2027

Laboratory DirectorMr. Athar Mujtaba

Laboratory Phone(929) 463-7190

Laboratory LocationMujtaba Np In Family Health PC10426 Roosevelt Ave, Corona, NY 11368

CLIA data matches this NPI record on: Address Name

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

AYESHA MUJTABA ARNP, CNM

Advanced Practice Midwife