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Individual

DR. ANDRE EDMOND BROUSSARD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1901 FIRST AVE, 523, NEW YORK, NY 10029
(212) 423-6228
(212) 534-7831
Mailing address
1901 1ST AVE, ROOM 523, NEW YORK, NY 10029-7404
(212) 423-6228
(212) 423-7697

Taxonomy

Speciality
Code
Description
License number
State
2080S0010X
Pediatric Sports Medicine Physician
Primary
MD126425
NY

Other

Enumeration date
10/19/2006
Last updated
11/29/2007
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