Individual provider Active NPI

Barbara Adzovi Meden-Bryant, RN

  • Gerontology Registered Nurse
  • Mount Vernon, NY
National Provider Identifier
1104567387
Registry record updated Apr 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Registered NurseTaxonomy code 163WG0600X
License
759311 Issued in NY
Practice address
302 Langdon Ave
Mount Vernon, NY 10553-1723
Phone
(646) 750-2076
NPI assigned
Apr 5, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Registered Nurse 163WG0600X 759311 NY Primary

Addresses

Primary practice location

302 Langdon Ave
Mount Vernon, NY 10553-1723

Mailing address

302 Langdon Ave
Mount Vernon, NY 10553-1723
Phone (646) 750-2076

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
759311NYMDGerontology Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1649116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649116800000",
    "number": "1104567387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 LANGDON AVE",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105531723",
            "telephone_number": "646-750-2076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 LANGDON AVE",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105531723",
            "telephone_number": "646-750-2076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDEN-BRYANT",
        "first_name": "BARBARA",
        "middle_name": "ADZOVI",
        "name_prefix": "Miss",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-05",
        "last_updated": "2022-04-05",
        "certification_date": "2022-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0600X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Gerontology",
            "state": "NY",
            "license": "759311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2022; 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.