Individual provider Active NPI

Stephan Angelo Brunache

  • Registered Nurse
  • Fairfield, CT
National Provider Identifier
1205747425
Registry record updated Sep 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
171766 Issued in CT
Practice address
5151 Park Ave
Fairfield, CT 06825-1000
Phone
(203) 371-7844
Fax
(203) 365-7662
NPI assigned
Sep 15, 2026
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163W00000X 171766 CT Primary

Addresses

Primary practice location

5151 Park Ave
Fairfield, CT 06825-1000

Mailing address

39 Oak St
Griswold, CT 06351-2405

Medicare participation

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

NPI Registry JSON

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

{
    "created_epoch": "1789430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789430400000",
    "number": "1205747425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 OAK ST",
            "city": "GRISWOLD",
            "state": "CT",
            "postal_code": "063512405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5151 PARK AVE",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068251000",
            "telephone_number": "203-371-7844",
            "fax_number": "203-365-7662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNACHE",
        "first_name": "STEPHAN",
        "middle_name": "ANGELO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-09-15",
        "last_updated": "2026-09-15",
        "certification_date": "2026-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse",
            "state": "CT",
            "license": "171766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.