Brian Lucas Kaczmarek, RN

Primary specialty

Adult Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0809X

License

705571 Issued in NY

Practice address

380 Genesee Ave
Staten Island, NY 10312-3296

Phone

(718) 984-3800

NPI assigned

Oct 6, 2020

Last updated

Jan 4, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1601942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704326400000",
    "number": "1457958118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 CORSON AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103012933",
            "telephone_number": "917-719-1885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 GENESEE AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103123296",
            "telephone_number": "718-984-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KACZMAREK",
        "first_name": "BRIAN",
        "middle_name": "LUCAS",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-06",
        "last_updated": "2024-01-04",
        "certification_date": "2024-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "NY",
            "license": "705571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Kaba
• Chhada Natan Kabariti, MD
• Renee Theresa Kabbez I
• Mohit Kabre
• Yana Kachina
• Urvi Kadakia, OTR/L
• Manali A Kadam, PT
• Ashish Kadinjicandy
• Buhalqem H Kadire, MD
• Armina Kadriovski

• Adult Psychiatric/Mental Health Registered Nurse in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Adult Psychiatric/Mental Health Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2024; 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.