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Export Provider Record NPI 1033150099
Malkhazi MikadzeMD
Active
NPI Number1033150099
NPI TypeNPI-1 Individual
SpecialtyPediatrics, Pediatric Emergency Medicine
Provider Details
NPI1033150099
NPI TypeNPI-1 Individual
StatusActive
Enumeration Date2006-06-09
Last Updated2025-01-02
Mailing Address224 E Northfield Rd
Livingston, NJ 07039-4801
United States
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Primary Practice Address30 Prospect Ave, Pediatrics Dept
Hackensack, NJ 07601-1914
United States
Phone: (201) 996-2000
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Taxonomy / Specialty
PrimaryTaxonomy Code & DescriptionStateLicense Number
No208000000X – PediatricsNJ25MA07954800
Yes2080P0204X – Pediatrics, Pediatric Emergency MedicineNJ25MA07954800
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About NPI 1033150099

Malkhazi Mikadze MD is a healthcare provider registered in the CMS NPPES NPI Registry with NPI number 1033150099. The primary specialty listed is Pediatrics, Pediatric Emergency Medicine. The provider is located in Hackensack, NJ. This NPI is classified as a Type 1 (Individual) NPI and is currently active. The NPI was first enumerated (assigned) on 2006-06-09. All data is sourced directly from the official CMS NPPES public API and is updated daily.

Frequently Asked Questions

What is NPI 1033150099?

NPI 1033150099 belongs to Malkhazi Mikadze MD, a Pediatrics, Pediatric Emergency Medicine in Hackensack, NJ. It is a Type 1 Individual NPI registered in the CMS NPPES NPI Registry.

Is NPI 1033150099 active?

The current status of NPI 1033150099 in the NPPES registry is Active. The record was last updated on 2025-01-02.

What specialty is NPI 1033150099?

NPI 1033150099 is classified under the taxonomy Pediatrics, Pediatric Emergency Medicine. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.

How do I verify NPI 1033150099?

You can verify NPI 1033150099 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.

What address is on file for NPI 1033150099?

The primary practice address on file for NPI 1033150099 is 30 Prospect Ave, Hackensack, NJ 07601-1914. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.

When was NPI 1033150099 issued?

NPI 1033150099 was first issued (enumerated) on 2006-06-09. The NPPES record was last updated on 2025-01-02.

Practice Location Map

Malkhazi Mikadze is located at 30 Prospect Ave, Hackensack, NJ. Use the map below to find directions or verify the practice location.

📍 30 Prospect Ave, Hackensack, NJ 07601-1914  ·  Open in Google Maps ↗

Related Healthcare Providers

The following providers share the same practice location, specialty, or state as Malkhazi Mikadze. All records sourced from the CMS NPPES registry.

License Information

The following state license numbers are on file in the NPPES registry for NPI 1033150099. For license status verification, contact the relevant state licensing board directly.

Specialty / TaxonomyLicense NumberState
Pediatrics25MA07954800NJ
Pediatrics, Pediatric Emergency Medicine25MA07954800NJ
Data Verified from CMS NPPES Last synced: 2026-07-27 · Source: npiregistry.cms.hhs.gov · 45 CFR Part 162