Organization
BROMEDICON PR INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANDRA L SILL (CREDENTIALING SPECIALIST)
(484) 351-8459
Entity
Organization
Contact information
Practice address
500 AVE MUNOZ RIVERA, SAN JUAN, PR 00918-3300
(484) 351-8459
(484) 351-8810
Mailing address
300 CONSHOHOCKEN STATE RD STE 450, CONSHOHOCKEN, PA 19428-3801
(484) 351-8459
(484) 351-8810
Taxonomy
Speciality
Code
Description
License number
State
204R00000X
Electrodiagnostic Medicine Physician
—
—
2084N0400X
Neurology Physician
—
—
2084N0600X
Clinical Neurophysiology Physician
Primary
—
—
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
—
—
Other
Enumeration date
05/24/2022
Last updated
08/11/2026
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