Individual
MR. ALAN BRODERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
REG PHARMACIST
Contact information
Practice address
136 SUMMIT ST, ENGLEWOOD, NJ 07631-4728
(201) 921-4276
(201) 568-2469
Mailing address
136 SUMMIT ST, ENGLEWOOD, NJ 07631-4728
(201) 921-4276
(201) 568-2469
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
025168
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
025168
LICENCE
NY
Enumeration date
02/09/2007
Last updated
07/08/2007
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