Debra L Prehoda, RN,BSN

Primary specialty

General Practice Registered NurseTaxonomy code 163WG0000X

License

3556841 Issued in NY

Practice address

9 Grand Ave
Mechanicville, NY 12118-2142

Phone

(518) 664-7719

NPI assigned

Mar 3, 2007

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

Credentials

Bachelor on Science - Nursing, Registered Nurse

State licenses

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

{
    "created_epoch": "1172880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1477682839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 MEADOW RUE PL",
            "city": "BALLSTON SPA",
            "state": "NY",
            "postal_code": "120204367",
            "telephone_number": "518-899-6796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 GRAND AVE",
            "city": "MECHANICVILLE",
            "state": "NY",
            "postal_code": "121182142",
            "telephone_number": "518-664-7719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PREHODA",
        "first_name": "DEBRA",
        "middle_name": "L",
        "credential": "RN,BSN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-03",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "NY",
            "license": "3556841",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01860282",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shilpkumar Patel, RPH
• Jan Louise Patterson, MD
• Petra V. Enzien, DMD, PLLC
• Laurie Phibbs, OTR/L
• Dana Lynn Pitaniello, M.S. CCC-SLP
• Marc David Price, D.O.
• Daniella A Reinoso-Gonzalez, M.S. ED.
• Kristin E Richter, RPH
• Hailey Rivers
• Chloe Robert, PHARMACY INTERN

• General Practice Registered Nurse in Mechanicville, NY
• Providers in Mechanicville, NY by specialty
• General Practice Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.