Dawn Houghtaling-Bryda

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

271469-1 Issued in NY

Practice address

32 Foster Rd
White Lake, NY 12786

Phone

(845) 239-9812

NPI assigned

Jun 18, 2018

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

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": "1529280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529280000000",
    "number": "1528552205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 651",
            "city": "SMALLWOOD",
            "state": "NY",
            "postal_code": "127780651",
            "telephone_number": "845-239-9812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 FOSTER RD",
            "city": "WHITE LAKE",
            "state": "NY",
            "postal_code": "12786",
            "telephone_number": "845-239-9812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOUGHTALING-BRYDA",
        "first_name": "DAWN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-18",
        "last_updated": "2018-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "271469-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bethel Medical Family Practice,PC
• Bethel Volunteer Ambulance Corp Inc
• Rachel Michelle Cirino, LMSW
• Laurie A Devine, CCC-SLP
• Colleen Mary Dobbs, R.N.
• Eric Bart London, MD
• Ninette Sanchez-Echi, MFT
• Inessa Shlifer, PA
• Tasha Watch, LPN

• Licensed Practical Nurse in White Lake, NY
• Providers in White Lake, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2018; 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.