Individual provider Active NPI

Wendy Maureen Brofman, RN

  • Registered Nurse
  • Northport, NY
National Provider Identifier
1831440916
Registry record updated Sep 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
609408 Issued in NY
Practice address
168 Bayview Ave
Northport, NY 11768-1564
Phone
(631) 757-6931
NPI assigned
Sep 28, 2012
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

LicenseStateTypeSpecialty
609408NYMDRegistered Nurse

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 609408 NY Primary

Addresses

NPPES NPI Registry

Primary practice location

168 Bayview Ave
Northport, NY 11768-1564

Mailing address

168 Bayview Ave
Northport, NY 11768-1564
Phone (631) 757-6931

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 28, 2012.

{
    "created_epoch": "1348790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348790400000",
    "number": "1831440916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "168 BAYVIEW AVE",
            "city": "NORTHPORT",
            "state": "NY",
            "postal_code": "117681564",
            "telephone_number": "631-757-6931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "168 BAYVIEW AVE",
            "city": "NORTHPORT",
            "state": "NY",
            "postal_code": "117681564",
            "telephone_number": "631-757-6931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROFMAN",
        "first_name": "WENDY",
        "middle_name": "MAUREEN",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-28",
        "last_updated": "2012-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "609408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northport, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2012; 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.