Individual
DR. ROBERT BRODERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1355 NORTHERN BLVD, STE 300, MANHASSET, NY 11030-3023
(516) 627-3232
(516) 365-1893
Mailing address
825 E GATE BLVD STE 111, GARDEN CITY, NY 11530-2136
(516) 804-5200
(516) 240-6540
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
141375
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1508649
—
NY
Enumeration date
06/13/2005
Last updated
09/09/2019
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