Organization
COMMONWEALTH PLASTIC SURGERY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GENEVIEVE B BRODERICK MD (OWNER)
(617) 472-6764
Entity
Organization
Contact information
Practice address
500 CONGRESS ST, SUITE B1, QUINCY, MA 02169-0908
(617) 472-6764
(617) 770-9933
Mailing address
500 CONGRESS ST, SUITE B1, QUINCY, MA 02169-0908
(617) 472-6764
(617) 770-9933
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
233883
MA
Other
Enumeration date
02/20/2015
Last updated
06/24/2015
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