Individual
MR. MILTON BARNEY BRODKOWITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS-AUDIOLOGIST
Contact information
Practice address
3 PENN PLZ E, NEWARK, NJ 07105-2258
(973) 522-1292
(973) 522-1294
Mailing address
PO BOX 406153, ATLANTA, GA 30384-1876
(561) 478-8770
(561) 598-7231
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
41YA00020200
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2490911000
AMERIHEALTH
NJ
01
—
81994
AMERIGROUP
NJ
Enumeration date
08/11/2006
Last updated
08/10/2009
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