Individual
MAUREEN BROGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3400 BAINBRIDGE AVE FL 2, BRONX, NY 10467-2404
(866) 633-8255
(718) 231-0293
Mailing address
3411 WAYNE AVE FL 5, BRONX, NY 10467-2535
(718) 920-5442
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
204688
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02176507
—
NY
01
—
A400062882
MEDICARE PTAN
NY
01
—
A400062887
MEDICARE PTAN
NY
Enumeration date
07/29/2005
Last updated
03/09/2023
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