MR. BROCTON FUNKE (NPI# 1316421654) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1316421654 |
Entity Type | Individual |
Full Name | MR. BROCTON FUNKE |
Credential | LMSW |
Practice Address |
333 Dexter Ter Tonawanda NY 14150-4747 |
Practice Telephone | 7169614050 |
Mailing Telephone | 7169614050 |
Enumeration Date | 2018-09-22 |
Last Update Date | 2018-09-22 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1041S0200X |
Social Worker Specialization: School |
1264947181 | NY | Behavioral Health & Social Service Providers |
Street Address |
333 DEXTER TER |
City | TONAWANDA |
State | NY |
Zip Code | 14150-4747 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1316397862 | Sally A Vicari | Counselor | 333 Dexter Ter, Tonawanda, NY 14150-4747 | 2016-06-15 |
1285234575 | Janice Marie Diaz | Social Worker | 333 Dexter Ter, Tonawanda, NY 14150-4747 | 2020-10-27 |
1730707357 | Monica Schaffstall | Speech-Language Pathologist | 333 Dexter Ter, Tonawanda, NY 14150-4747 | 2020-07-09 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1891349338 | Jennifer Legrand | Dietitian, Registered | 62 Raintree Is Apt 10, Tonawanda, NY 14150 | 2019-08-01 |
1245707934 | Anthony John Dellavalle | Emergency Medicine | 341 Niagara Street, Tonawanda, NY 14150 | 2018-10-31 |
1871088450 | Karen Mittlefehldt | Physical Therapist | 2540 Sheridan Drive, Tonawanda, NY 14150 | 2018-06-26 |
1871017194 | Amanda Beth Mrzygut | Emergency Medical Technician, Basic | 269 Mapleview Dr, Tonawanda, NY 14150 | 2017-07-28 |
1700248648 | Nathan Willett | Technician, Other | 432 Forbes Ave., Tonawanda, NY 14150 | 2016-03-21 |
1831555432 | Safe Ride of Wny Inc | Taxi | 2813 Niagara St, Tonawanda, NY 14150 | 2016-01-12 |
1447509278 | Nancy Lynne Haas | Licensed Practical Nurse | 173 Linwood Ave, Tonawanda, NY 14150 | 2012-09-07 |
1558646331 | Nancy Cliff | Registered Nurse | 39 O'hara Rd, Tonawanda, NY 14150 | 2011-10-12 |
1801195979 | Joann Mirabella | Speech-Language Pathologist | 313 Wrexham Ct. North, Tonawanda, NY 14150 | 2011-03-15 |
1841593829 | Marie A Burger | Social Worker | 130 Syracuse St., Tonawanda, NY 14150 | 2010-12-13 |
Find all providers in zip 14150 |
Taxonomy Code | 1041S0200X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Social Worker |
Specialization | School |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1285234575 | Janice Marie Diaz | Social Worker | 333 Dexter Ter, Tonawanda, NY 14150-4747 | 2020-10-27 |
1730734575 | Mary Rose Wittman | Social Worker | 100 Hinds St, Tonawanda, NY 14150-1815 | 2019-08-08 |
1962806810 | Joelle Labert | Social Worker | 600 Fletcher St, Tonawanda, NY 14150-3616 | 2014-10-21 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1710584891 | Alliah Irtan | Social Worker | 20 Randall Ave Apt 3m, Freeport, NY 11520-2756 | 2020-10-02 |
1144834045 | Luis Steven Maisonet | Social Worker | 255 Porter Ave, Buffalo, NY 14201-1051 | 2020-09-08 |
1386258135 | Kimberly Lama Khan | Social Worker | 301 Henry St Fl 1, New York, NY 10002-4840 | 2020-08-31 |
1801406327 | Simone Curling | Social Worker | 93 Lewis Ave Apt 10a, Brooklyn, NY 11206-7031 | 2020-08-10 |
1720604622 | Matthew Joseph Danis | Social Worker | 219 W 15th St Apt 1f, New York, NY 10011-6449 | 2020-06-17 |
1710512538 | Carmen I Ramos | Social Worker | 580 Castle Hill Ave Apt 7a, Bronx, NY 10473-1514 | 2020-03-12 |
1134753429 | Susan London | Social Worker | 5 Peter Cooper Rd Apt Me, New York, NY 10010-6635 | 2020-02-26 |
1952948432 | Esmeralda Murati | Social Worker | 65 Tuckahoe Ave, Eastchester, NY 10709-3624 | 2019-12-04 |
1588209415 | Tenisha Neil-robinson | Social Worker | Rockland Boces, 65 Parrott Road, West Nyack, NY 10994 | 2019-11-14 |
1891345781 | Danielle Tooley | Social Worker | 403 Broadway, Kingston, NY 12401-4625 | 2019-09-12 |
Find all providers with the same taxonomy |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.