Amber Lee Brazee

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

10 274384 Issued in NY

Practice address

137 Hinsdale Rd
Mattydale, NY 13211-1207

Phone

(315) 882-8640

NPI assigned

Jul 14, 2010

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

State licenses

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

{
    "created_epoch": "1279065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279065600000",
    "number": "1629380035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "137 HINSDALE RD",
            "city": "MATTYDALE",
            "state": "NY",
            "postal_code": "132111207",
            "telephone_number": "315-882-8640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "137 HINSDALE RD",
            "city": "MATTYDALE",
            "state": "NY",
            "postal_code": "132111207",
            "telephone_number": "315-882-8640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAZEE",
        "first_name": "AMBER",
        "middle_name": "LEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-14",
        "last_updated": "2010-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "10 274384",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02728756",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Justin Christopher Acker, PHARM.D. RPH.
• Emily Alfieri, LMT
• Jodi Arquitt
• Leah Marie Bennett, LMT
• Sarah Frances Blackwelder, LPN
• Alisha Calkins
• Elaine Marie Ciferni, LMT
• Clinton Charles Conger, D.C.
• Theresa M Covington, PH.D.
• Tanya Cremins, LPN

• Licensed Practical Nurse in Mattydale, NY
• Providers in Mattydale, 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 Jul 14, 2010; 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.