Individual
SCOTT BRODERICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
118 ALGONQUIN PK, PLATTSBURGH, NY 12901
(518) 572-8780
Mailing address
118 ALGONQUIN PARK, PLATTSBURGH, NY 12901-1193
(518) 572-8780
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
04/03/2013
Last updated
04/03/2013
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