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Individual

JEFFREY M BRODY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
593 EDDY ST, PROVIDENCE, RI 02903-4923
(401) 444-5174
(401) 453-8220
Mailing address
125 METRO CENTER BLVD STE 2000, WARWICK, RI 02886-1785
(401) 432-2520
(401) 453-8220

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
154853
MA
2085R0202X
Diagnostic Radiology Physician
Primary
MD08159
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000001988
NHPRI
01
003109685
MED ASSISTANCE
CT
01
004491
BLUECHIP
01
007002783
HOSPITAL PIN
01
007056
TUFTS
01
008159
BLUESHIELD
01
1600203
UNITED HEALTH PLANS
01
240090
RIH PILGRIM
01
240166
W AND I PILGRIM
01
3198243
HEALTHY START
05
3198243
MA
01
7002783
MEDICAL ASSISTANCE
RI
01
720052301
CIGNA
01
8159
FEP BLUECROSS
Enumeration date
10/14/2005
Last updated
03/15/2024
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