Organization
BROOME DEVELOPMENTAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MANGALA PUTTANIAH MD (MEDICAL DIRECTOR)
(607) 770-0348
Entity
Organization
Contact information
Practice address
249 GLENWOOD RD, BINGHAMTON, NY 13905-1603
(607) 770-0348
Mailing address
249 GLENWOOD RD, BINGHAMTON, NY 13905-1603
(607) 770-0348
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
006396-1
NY
Other
Enumeration date
05/29/2007
Last updated
06/20/2008
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