Bruce W Elmendorf, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

522232-1 Issued in NY

Practice address

55 Ramble Hill Lane
Millbrook, NY 12545

Phone

(845) 677-9500

NPI assigned

Jul 2, 2008

Last updated

Jul 2, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Credentials

Registered Nurse

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Daytop Village, Inc.

  • Substance Abuse Rehabilitation Facility
  • Millbrook, NY
  • NPI 1457472136
  NPD (past)

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

{
    "created_epoch": "1214956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214956800000",
    "number": "1801058623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 RAMBLE HILL LANE",
            "city": "MILLBROOK",
            "state": "NY",
            "postal_code": "12545",
            "telephone_number": "845-677-9500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 RAMBLE HILL LANE",
            "city": "MILLBROOK",
            "state": "NY",
            "postal_code": "12545",
            "telephone_number": "845-677-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELMENDORF",
        "first_name": "BRUCE",
        "middle_name": "W",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-02",
        "last_updated": "2008-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "522232-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "522232-1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matthew Donovan, COTA
• Erin Downs
• Dr Suzanne a Murphy DC PC
• Dr. David Stamm, DPM, PC
• Emma Kisslinger Dweck, M.AC., L.AC.
• Judith M Fox, A.T.,C.
• Signy Furiya, LCSW
• Kimberly Ann Gann Volpe, COTA
• Christie Dorothy Garb, MD
• Daren Garb, M.D.

• Registered Nurse in Millbrook, NY
• Providers in Millbrook, NY by specialty
• Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2008; 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.