Individual
THOMAS F BRODERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
195 INDUSTRIAL PKWY, NVRH CORNER MEDICAL, LYNDON, VT 05849
(802) 748-9501
Mailing address
PO BOX 905, ST JOHNSBURY, VT 05819-0905
(802) 748-8141
(802) 748-4098
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
7599
NH
207Q00000X
Family Medicine Physician
Primary
032-0000286
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0005681
—
VT
05
—
3074951
—
NH
Enumeration date
07/06/2006
Last updated
04/14/2022
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