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Individual

JEFFREY T. BRODSKY

Active
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Individual

JEFFREY T. BRODSKY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

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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