Individual provider Active NPI

Glenda Lynn Brzoska

  • Speech-Language Pathologist
  • Hamburg, NY
National Provider Identifier
1699921528
Registry record updated Apr 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
008117-1 Issued in NY
Practice address
2584 Amsdell Rd
Hamburg, NY 14075-5738
Phone
(716) 627-6756
NPI assigned
Aug 12, 2008
Last updated
Apr 11, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 008117-1 NY Primary

Addresses

Primary practice location

2584 Amsdell Rd
Hamburg, NY 14075-5738

Mailing address

2584 Amsdell Rd
Hamburg, NY 14075-5738
Phone (716) 627-6756

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

State licenses

LicenseStateTypeSpecialty
008117-1NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1218499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270944000000",
    "number": "1699921528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2584 AMSDELL RD",
            "city": "HAMBURG",
            "state": "NY",
            "postal_code": "140755738",
            "telephone_number": "716-627-6756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2584 AMSDELL RD",
            "city": "HAMBURG",
            "state": "NY",
            "postal_code": "140755738",
            "telephone_number": "716-627-6756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRZOSKA",
        "first_name": "GLENDA",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-12",
        "last_updated": "2010-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "008117-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamburg, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 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.