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Individual

MATTHEW J BROUDY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LMT

Contact information

Practice address
925 ROUTE 6, MAHOPAC, NY 10541-1772
(845) 628-3805
(845) 628-3833
Mailing address
31 FINNEY FARM RD, CROTON ON HUDSON, NY 10520-1904

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
026261
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
026261
MASSAGE THERAPY LICENSE
NY
Enumeration date
10/28/2024
Last updated
10/28/2024
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