Jacalyn Bruno, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

Practice address

55 Weeks St
Blue Point, NY 11715-1516

Phone

(641) 438-1220

NPI assigned

Sep 5, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Child Psychology of Long Island

  • Clinical Child & Adolescent Psychologist
  • Blue Point, NY
  • NPI 1003480799
  NPD Authorized official

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

{
    "created_epoch": "1504569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583971200000",
    "number": "1356869812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 LONGWOOD RD",
            "city": "MIDDLE ISLAND",
            "state": "NY",
            "postal_code": "119532045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 WEEKS ST",
            "city": "BLUE POINT",
            "state": "NY",
            "postal_code": "117151516",
            "telephone_number": "641-438-1220"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "35 Longwood Rd",
            "address_purpose": "LOCATION",
            "city": "Middle Island",
            "state": "NY",
            "postal_code": "119532045",
            "country_code": "US",
            "telephone_number": "631-924-0008",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRUNO",
        "first_name": "JACALYN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-05",
        "last_updated": "2020-03-12",
        "certification_date": "2020-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carlie Christina Boss
• Lauren Marie Bozza
• Janice Bradshaw, RN
• Mercedes Brooks
• Catherine Brown
• Tonya Bryant
• Laura Ann Buckheit
• Wanda Burger
• Morgan Amelia Burke, RN
• Alexandra Lynn Busch

• Psychologist in Blue Point, NY
• Providers in Blue Point, NY by specialty
• Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2020; 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.