Three Village Neurology, P.C.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

Legal business name

THREE VILLAGE NEUROLOGY, P.C.

Practice address

4511 Nesconset Hwy
Port Jefferson Station, NY 11776-2630

Phone

(631) 751-0790

Fax

(631) 675-1022

NPI assigned

May 12, 2006

Organization subpart

No

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

Authorized official

Name

Dr. James D Bruno, M.D.NPI 1750436879

Title

Ceo

Phone

(631) 751-0790

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• James Dominick Bruno, M.D.

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

  • Neurology Physician
  • Stony Brook, NY
  • NPI 1346292869
  NPD (past)
• Warren Daniel Spinner, D.O.

  • Neurology Physician
  • Port Jefferson Station, NY
  • NPI 1164617544
  NPD (past)

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670544000000",
    "number": "1871544015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4511 NESCONSET HWY",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117762630",
            "telephone_number": "631-751-0790",
            "fax_number": "631-675-1022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4511 NESCONSET HWY",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117762630",
            "telephone_number": "631-751-0790",
            "fax_number": "631-675-1022"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2500 Nesconset Hwy",
            "address_2": "Building 21 B",
            "address_purpose": "LOCATION",
            "city": "Stony Brook",
            "state": "NY",
            "postal_code": "117902555",
            "country_code": "US",
            "telephone_number": "631-751-0790",
            "fax_number": "631-751-4347",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "THREE VILLAGE NEUROLOGY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-12",
        "last_updated": "2022-12-09",
        "certification_date": "2022-12-09",
        "status": "A",
        "authorized_official_last_name": "BRUNO",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "631-751-0790",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "234763",
            "primary": false
        },
        {
            "code": "2084E0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Epilepsy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084S0012X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Sleep Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAXONOMY",
            "identifier": "2084N0400X",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thomas P. Erhart DO PC
• Shani Thomas
• Lori Thompson, LMHC; NCC
• Lynnette Thompson, LPN
• Kayla Thorsen, OTR/L
• Barbara Tierno
• Bernadette Marie Timko, OTR/L
• Gerardo Tolentino, M.D.
• Alfredo Enrique Torres Gonzalez, M.D
• Ramon Torres

• Neurology Physician in Port Jefferson Station, NY
• Providers in Port Jefferson Station, NY by specialty
• Neurology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2022; 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.