Individual
DR. JOHN DENNIS BRODERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7755 CENTER AVE STE 630, HUNTINGTON BEACH, CA 92647-9152
(657) 400-5180
Mailing address
15 FENIMORE PL, GANSEVOORT, NY 12831-1476
(518) 306-5908
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
210877-2
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01862431
—
NY
Enumeration date
08/11/2005
Last updated
07/31/2025
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