=====================================================
General NPI Number Information
=====================================================
NPI Number | 1629929658
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BRIANA CLOUTIER RPN
-----------------------------------------------------
Gender |
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/05/2026
-----------------------------------------------------
Last Update Date | 02/05/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 672 PARKSIDE AVE STE 2
-----------------------------------------------------
City | BROOKLYN
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11226-2990
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-246-5700
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 672 PARKSIDE AVE STE 2
-----------------------------------------------------
City | BROOKLYN
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11226-2990
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-246-5700
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163WD0400X
-----------------------------------------------------
Taxonomy Name | Diabetes Educator Registered Nurse
-----------------------------------------------------
License Number | 972305
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 163W00000X
-----------------------------------------------------
Taxonomy Name | Registered Nurse
-----------------------------------------------------
License Number | 972305
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------