Individual
GREGG BROFFMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
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
Update your record
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