Active NPI
Fanny Brewster, PH.D.
- Psychoanalyst
- Brooklyn, NY
National Provider Identifier
1629227426
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychoanalyst
- License
- 000890-1
- Practice address
- 30 3Rd Ave
Brooklyn, NY 11217-1822 - Phone
- (917) 257-6512
- NPI assigned
- Sep 17, 2008
- Last updated
- Nov 5, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 09137-1 | NY | |
| Psychoanalyst | 102L00000X | 000890-1 | NY | Primary |
Addresses
Primary practice location
30 3Rd Ave
Brooklyn, NY 11217-1822
Mailing address
30 3Rd Ave
Brooklyn, NY 11217-1822
Phone (917) 257-6512
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
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000890-1 | NY | MD | Psychoanalyst |
| 09137-1 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1221609600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604534400000",
"number": "1629227426",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 3RD AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112171822",
"telephone_number": "917-257-6512"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 3RD AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112171822",
"telephone_number": "917-257-6512"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BREWSTER",
"first_name": "FANNY",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-09-17",
"last_updated": "2020-11-05",
"certification_date": "2020-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "09137-1",
"primary": false
},
{
"code": "102L00000X",
"taxonomy_group": "",
"desc": "Psychoanalyst",
"state": "NY",
"license": "000890-1",
"primary": true
}
],
"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 Nov 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.