Individual
GREGG BROFFMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
120 GARDENVILLE PKWY, WEST SENECA, NY 14224
(716) 668-3600
(716) 565-4223
Mailing address
800 CARTER ST, ATTN KELLY STEELE, ROCHESTER, NY 14621
(585) 339-4793
(585) 336-4845
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
131752
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000089397
GHI
NY
01
—
00010021101
UNIVERA
NY
01
—
000500324010
BCBS
NY
01
—
050216000044
FIDELIS
NY
01
—
050216000049
FIDELIS
NY
01
—
10495518
CAQH
NY
01
—
10520422
CAQH
NY
01
—
159628DL
PREFERRED CARE
NY
01
—
P00201738
MEDICARE RAILROAD
NY
Enumeration date
05/16/2006
Last updated
07/08/2007
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