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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
100 FRONT ST STE 280, CONSHOHOCKEN, PA 19428-2891
(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
12/08/2025
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