Breona Petteway Support Services Incorporated

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

Legal business name

BREONA PETTEWAY SUPPORT SERVICES INCORPORATED

Practice address

18 Lake Dr
Wyandanch, NY 11798-3430

Phone

(934) 256-2441

Fax

(934) 256-2441

NPI assigned

Jan 27, 2026

Organization subpart

No

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

Authorized official

Name

Breona PettewayNPI 1225701303

Title

LPN

Phone

(934) 256-2441

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Breona Petteway

  • Licensed Practical Nurse
  • Syracuse, NY
  • NPI 1225701303
  NPD Authorized official

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

{
    "created_epoch": "1769472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769472000000",
    "number": "1194674622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 STATE ST STE 80416264",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122072540",
            "telephone_number": "934-256-2441",
            "fax_number": "934-256-2441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 LAKE DR",
            "city": "WYANDANCH",
            "state": "NY",
            "postal_code": "117983430",
            "telephone_number": "934-256-2441",
            "fax_number": "934-256-2441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREONA PETTEWAY SUPPORT SERVICES INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-27",
        "last_updated": "2026-01-27",
        "certification_date": "2026-01-27",
        "status": "A",
        "authorized_official_last_name": "PETTEWAY",
        "authorized_official_first_name": "BREONA",
        "authorized_official_title_or_position": "LPN",
        "authorized_official_telephone_number": "934-256-2441"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Licensed Practical Nurse",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tanya Bates, B.A./CASAC-T/NYSCNA
• Belinda a Marquis,MD,PC
• Ashley Berry, LCSW-R
• Katelyn Paige Bogi, NURSE
• Ahniyah Boyd
• Ishiemah S Brooks
• Cheryl A Brown, COTA
• Karen Budzenski
• Ivy Bullock
• Kenmar Bunwarrie

• Licensed Practical Nurse in Wyandanch, NY
• Providers in Wyandanch, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2026; 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.