Organization
JAMES E. BRODERICK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES E BRODERICKD DPM (PODIATRIST)
(585) 394-4070
Entity
Organization
Contact information
Practice address
470 S PEARL ST, CANANDAIGUA, NY 14424-1702
(585) 394-4070
(585) 394-8563
Mailing address
470 S PEARL ST, CANANDAIGUA, NY 14424-1702
(585) 394-4070
(585) 394-8563
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
N004540
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01158323
—
NY
Enumeration date
05/19/2010
Last updated
05/19/2010
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