Individual provider Active NPI

Mireille Brunache

  • Licensed Practical Nurse
  • Brooklyn, NY
National Provider Identifier
1073808911
Registry record updated Jun 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
289477 Issued in NY
Practice address
803 E 49TH St
2B
Brooklyn, NY 11203-5839
Phone
(347) 789-6320
NPI assigned
Jun 17, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 289477 NY Primary

Addresses

Primary practice location

803 E 49TH St
2B
Brooklyn, NY 11203-5839

Mailing address

803 E 49TH St
2B
Brooklyn, NY 11203-5839
Phone (347) 789-6320

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
289477NYMDChild & Adolescent Psychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1308268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308268800000",
    "number": "1073808911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "803 E 49TH ST",
            "address_2": "2B",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112035839",
            "telephone_number": "347-789-6320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "803 E 49TH ST",
            "address_2": "2B",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112035839",
            "telephone_number": "347-789-6320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNACHE",
        "first_name": "MIREILLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-17",
        "last_updated": "2011-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "289477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2011; 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.