Individual
JONATHAN BROMBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
16 S EUTAW ST FL 1, BALTIMORE, MD 21201-1606
(410) 328-5408
Mailing address
PO BOX 64226, BALTIMORE, MD 21264-4226
(410) 328-0008
Taxonomy
Speciality
Code
Description
License number
State
204F00000X
Transplant Surgery Physician
213609
NY
204F00000X
Transplant Surgery Physician
Primary
D71017
MD
208600000X
Surgery Physician
213609
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02094439
—
NY
Enumeration date
02/23/2006
Last updated
02/13/2019
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