Provider Demographics
NPI:1043941503
Name:MUSA, DOHA
Entity Type:Individual
Prefix:
First Name:DOHA
Middle Name:
Last Name:MUSA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 UNION AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10303-2425
Mailing Address - Country:US
Mailing Address - Phone:646-589-3804
Mailing Address - Fax:
Practice Address - Street 1:20 UNION AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10303-2425
Practice Address - Country:US
Practice Address - Phone:646-589-3804
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-23
Last Update Date:2023-06-24
Deactivation Date:2022-08-09
Deactivation Code:
Reactivation Date:2023-06-21
Provider Licenses
StateLicense IDTaxonomies
NY235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist