Provider Demographics
NPI:1699094441
Name:MCGUIRE, BRENDA (NP)
Entity type:Individual
Prefix:
First Name:BRENDA
Middle Name:
Last Name:MCGUIRE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4209 28TH ST # CN-48
Mailing Address - Street 2:
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11101-4130
Mailing Address - Country:US
Mailing Address - Phone:347-396-6299
Mailing Address - Fax:347-396-6367
Practice Address - Street 1:295 FLATBUSH AVENUE EXT FL 2
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-3001
Practice Address - Country:US
Practice Address - Phone:347-396-6299
Practice Address - Fax:347-396-6367
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-19
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY594089-1163W00000X
NYF342339-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY594089-1OtherTHE UNIVERSITY OF THE STATE OF NEW YORK/REGISTERED PROFESSIONAL NURSE
NYF342339-1OtherTHE UNIVERSITY OF THE STATE OF NEW YORK