BREONA PETTEWAY SUPPORT SERVICES INCORPORATED
NPI 1194674622
Licensed Practical Nurse in Wyandanch, NY

Q: What is Breona Petteway Support Services Incorporated's specialty?

The primary specialty registered for this NPI is Licensed Practical Nurse with taxonomy code 164W00000X.

Active since January 27, 2026

18 LAKE DR, WYANDANCH, NY 11798(934) 256-2441(934) 256-2441 Get Directions Write a Review

NPPES record last updated: January 27, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Breona Petteway Support Services Incorporated NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BREONA PETTEWAY SUPPORT SERVICES INCORPORATED (NPI 1194674622) is a healthcare organization registered as a licensed practical nurse in Wyandanch, New York and active in the NPI registry since January 2026. The organization lists Breona Petteway, Lpn, as its authorized official.

NPPES Registry Identity

NPI1194674622

Entity TypeOrganization

Primary Taxonomy164W00000X

Legal Business NameBREONA PETTEWAY SUPPORT SERVICES INCORPORATED

Location Address18 LAKE DRWyandanch, NY 11798-3430

Mailing Address54 State St Ste 80416264Albany, NY 12207-2540 · (934) 256-2441 · Fax (934) 256-2441

Phone(934) 256-2441

Fax(934) 256-2441

Organization SubpartNo

Authorized OfficialBreona PettewayLpn · (934) 256-2441

Enumeration DateJanuary 27, 2026

NPPES CertifiedJanuary 27, 2026

✔ NPI 1194674622 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyLicensed Practical NurseNursing Service Providers

Taxonomy Code164W00000X

Definition

A licensed practical nurse with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

18 LAKE DR, Wyandanch, NY 11798

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Breona Petteway Support Services Incorporated's NPI number?

The NPI number for Breona Petteway Support Services Incorporated is 1194674622. It was assigned to this organization in the NPPES registry on January 27, 2026.

Where is Breona Petteway Support Services Incorporated located?

Breona Petteway Support Services Incorporated is located at 18 Lake Dr, Wyandanch, NY 11798. The listed phone number is (934) 256-2441.

What is Breona Petteway Support Services Incorporated's specialty?

The primary specialty registered for this NPI is Licensed Practical Nurse with taxonomy code 164W00000X.

When was this NPI record last updated?

The NPPES record for Breona Petteway Support Services Incorporated was last updated on January 27, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.