Bracha Fishman

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

BRACHA FISHMAN

Practice address

88 Terry Rd Ste 101
Smithtown, NY 11787-3811

Phone

(917) 686-2412

NPI assigned

May 27, 2022

Organization subpart

No

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

Authorized official

Name

Bracha Oriana Fishman, RNNPI 1144869710

Title

Owner

Phone

(917) 686-2412

Specialties & licenses 6

Addresses

Other names 1

• Eden Health Mental Wellness Doing business as

Locations

Practitioners 1

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

• Bracha Oriana Fishman

  • Mental Health Counselor
  • Smithtown, NY
  • NPI 1144869710

  Registered Nurse

  NPD Authorized official

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

{
    "created_epoch": "1653609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686787200000",
    "number": "1205575388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "88 TERRY RD UNIT 12",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117873811",
            "telephone_number": "917-686-2412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "88 TERRY RD STE 101",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117873811",
            "telephone_number": "917-686-2412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRACHA FISHMAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-27",
        "last_updated": "2023-06-15",
        "certification_date": "2023-06-15",
        "status": "A",
        "authorized_official_last_name": "FISHMAN",
        "authorized_official_first_name": "BRACHA",
        "authorized_official_middle_name": "ORIANA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-686-2412",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163WP0807X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Child & Adolescent",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163WP0809X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eden Health Mental Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Claire Bowles, MHC-LP
• Kelly J Boyd, LMSW
• Lisa Marie Boyd
• Lorie Vanessa Boyd, LMHC
• Joshua Peter Bozek, D.O.
• Kimberly Brady-Marder
• Robert James Brancale, PHARMD
• Branch Medical Associates, P.C.
• Branch Pediatrics and Adolescent Group P.C.
• Robert Donald Branch Jr., PA

• Multi-Specialty Clinic/Center in Smithtown, NY
• Providers in Smithtown, NY by specialty
• Multi-Specialty Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2023; 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.