Individual
JEFFREY T. BRODSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1240 S CEDAR CREST BLVD, SUITE 205, ALLENTOWN, PA 18103-6369
(610) 402-7884
(610) 402-8876
Mailing address
PO BOX 783311, PHILADELPHIA, PA 19178-3311
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
MD043314L
PA
2086X0206X
Surgical Oncology Physician
Primary
MD043314L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001244181
—
PA
05
—
0012441810012
—
PA
05
—
0012441810013
—
PA
05
—
0012441810014
—
PA
01
—
0506425000
KEYSTONE IBC
PA
01
—
4208659
AETNA
PA
01
—
673140
HIGHMARK BLUE SHIELD
PA
01
—
P00251847
RAILROAD MEDICARE
PA
Enumeration date
11/23/2005
Last updated
11/27/2015
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