Joanne Brennan, RN, CPN
Individual provider Active NPI Pediatric Registered Nurse · Brightwaters, NY
NPI 1649455155 · NPPES record last updated Jan 2, 2008
Key facts
- NPI
- 1649455155
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Registered Nurse 163WP0200X
- License
- 291864-1 (NY)
- Practice address
- 104 Wohseepee Dr
Brightwaters, NY 11718-1816 - Phone
- (631) 666-9029
- NPI assigned
- Jan 2, 2008
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 291864-1 | NY | MD | Pediatric Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Registered Nurse | 163WP0200X | 291864-1 | NY | Yes |
Addresses
Primary practice location
104 Wohseepee Dr
Brightwaters, NY 11718-1816
Mailing address
104 Wohseepee Dr
Brightwaters, NY 11718-1816
Phone (631) 666-9029
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02498240 | Medicaid | NY |
Other providers in Brightwaters, NY
- Shane Arikian
- Robert James Balzarano
- Angela Lauria Baumann
- Brianna Lee Blaskey
- Julia Dlhopolsky Block
- Bright Bay Physical Therapy P.C.
- Bright Water Medical Procedure Suite, PLLC
- Andrew Burton
- Paul Cain
- Care First Anesthesia Professionals, PLLC
All providers in Brightwaters, NY · Pediatric Registered Nurse in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 2, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.