Three Village Neurophysiology, PLLC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

234763 Issued in NY

Legal business name

THREE VILLAGE NEUROPHYSIOLOGY, PLLC

Practice address

5 Alilah CT
Miller Place, NY 11764-1902

Phone

(631) 521-4137

NPI assigned

May 18, 2009

Last updated

May 18, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. James Bruno, M.D.NPI 1750436879

Title

President

Phone

(631) 521-4137

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• James Dominick Bruno, M.D.

  • Neurology Physician
  • Stony Brook, NY
  • NPI 1750436879
  Medicare reassignment Authorized official
• Deborah Galloway, M.D.

  • Neurology Physician
  • Stony Brook, NY
  • NPI 1346292869
  NPD (past)

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

{
    "created_epoch": "1242604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242604800000",
    "number": "1861627077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 ALILAH CT",
            "city": "MILLER PLACE",
            "state": "NY",
            "postal_code": "117641902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 ALILAH CT",
            "city": "MILLER PLACE",
            "state": "NY",
            "postal_code": "117641902",
            "telephone_number": "631-521-4137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THREE VILLAGE NEUROPHYSIOLOGY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-18",
        "last_updated": "2009-05-18",
        "status": "A",
        "authorized_official_last_name": "BRUNO",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-521-4137",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NY",
            "license": "234763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert M Streb, PT
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• Chelsea Tirone
• Alexander A Tocher, M.D.
• Jennifer Olivia Treubig, RDN
• John Michael Tumminello, SLP
• Lauren Ashley Turner, RN

• Medical Specialty Clinic/Center in Miller Place, NY
• Providers in Miller Place, NY by specialty
• Medical Specialty Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.