Individual
DR. KRISTIN ROYCE BRODIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
123 FANCHER RD, BRIDGEWATER CORNERS, VT 05035-9736
(315) 436-8864
Mailing address
PO BOX 382, BRIDGEWATER CORNERS, VT 05035-0382
(315) 436-8864
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
178242-01
NY
207Y00000X
Otolaryngology Physician
Primary
1782421
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01132609
—
NY
Enumeration date
05/02/2007
Last updated
12/08/2023
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