Individual
BREANNA CLAIRE BRODSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
56 MARILYN DR, GRAND ISLAND, NY 14072-2632
(716) 297-0798
(716) 297-0998
Mailing address
56 MARILYN DR, GRAND ISLAND, NY 14072-2632
(716) 297-0798
(716) 297-0998
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1402313
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1402313
NEW YORK STATE LICENSE
NY
Enumeration date
08/10/2016
Last updated
08/10/2016
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