Miriam Lois Brunnwasser, SPECIAL EDUCATOR

Primary specialty

SpecialistTaxonomy code 174400000X

License

1516824 Issued in NY

Practice address

9805 67TH Ave
Rego Park, NY 11374-4969

Phone

(718) 997-0880

NPI assigned

Jun 17, 2012

Last updated

Jun 17, 2012By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1339891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339891200000",
    "number": "1417210311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9805 67TH AVE APT 4-0",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113744969",
            "telephone_number": "718-997-0880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9805 67TH AVE",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113744969",
            "telephone_number": "718-997-0880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNNWASSER",
        "first_name": "MIRIAM",
        "middle_name": "LOIS",
        "name_prefix": "Ms.",
        "credential": "SPECIAL EDUCATOR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-17",
        "last_updated": "2012-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "1516824",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EARLY INTERVENTION DEPARTMENT OF HEALTH",
            "identifier": "174400000X",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Laquana Melissa Brown, NP
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• Karla Buchanan
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• Specialist in Rego Park, NY
• Providers in Rego Park, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2012; 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.