Debora Bruder, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

423403 Issued in NY

Practice address

300 W Main St
Smithtown, NY 11787-2611

Phone

(631) 549-9500

NPI assigned

Apr 28, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Debora Jean La Guardia Professional name

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 and National Provider Directory roles.

• Community Care Companions, Inc.

  • Home Health Agency
  • Smithtown, NY
  • NPI 1427379114
  NPD (past)

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

{
    "created_epoch": "1651104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651104000000",
    "number": "1861137416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W MAIN ST",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117872611",
            "telephone_number": "631-549-9500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W MAIN ST",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117872611",
            "telephone_number": "631-549-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUDER",
        "first_name": "DEBORA",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-28",
        "last_updated": "2022-04-28",
        "certification_date": "2022-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "423403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEBORA",
            "last_name": "LA GUARDIA",
            "middle_name": "JEAN",
            "credential": "RN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Tracey Brown, NPP
• C Browne
• Lisa D Browning, LMSW
• Antonietta Bruccoleri, LCSW
• Patricia Bruckenthal, NP
• Scott Eric Brunengraber, D.C.
• Mackenzie Ann Brunquell
• Tara Marie Brunswick, M.S., L. C. S. W.
• Crystal M Bryson
• BSL Smithtown Operations, Inc.

• Registered Nurse in Smithtown, NY
• Providers in Smithtown, 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 Apr 28, 2022; 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.