Individual provider Active NPI

Koren Philene Brigham, MA

  • Specialist
  • Brooklyn, NY
National Provider Identifier
1518212190
Registry record updated Jul 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
632812121 Issued in NY
Practice address
31 Prospect PL
Brooklyn, NY 11217-2801
Phone
(917) 855-3908
NPI assigned
Jul 19, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2012

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 632812121 NY Primary
Specialist 174400000X 632817121 NY
Specialist 174400000X 632816121 NY
Specialist 174400000X 632811121 NY

Addresses

Primary practice location

31 Prospect PL
Brooklyn, NY 11217-2801

Mailing address

31 Prospect PL
Brooklyn, NY 11217-2801
Phone (917) 855-3908

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
632811121NYMDSpecialist
632812121NYMDSpecialist
632816121NYMDSpecialist
632817121NYMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1342656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342656000000",
    "number": "1518212190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 PROSPECT PL",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112172801",
            "telephone_number": "917-855-3908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 PROSPECT PL",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112172801",
            "telephone_number": "917-855-3908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRIGHAM",
        "first_name": "KOREN",
        "middle_name": "PHILENE",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-19",
        "last_updated": "2012-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "632812121",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "632817121",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "632816121",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "632811121",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 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.