Healthcare Provider Details

I. General information

NPI: 1629990411
Provider Name (Legal Business Name): NAWAL MUSTAFA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 WOODS RD
VALHALLA NY
10595-1530
US

IV. Provider business mailing address

314 E 84TH ST APT 1
NEW YORK NY
10028-4477
US

V. Phone/Fax

Practice location:
  • Phone: 914-493-1939
  • Fax:
Mailing address:
  • Phone: 332-234-7920
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: